Interstitial lung disease and sleep: What is known?

Agarwal, Shikhar; Richardson, Brittany; Krishnan, Vidya; Schneider, Hartmut; Collop, Nancy A.; Danoff, Sonye K.

doi:10.1016/j.sleep.2009.01.004

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Volume 10, Issue 9 , Pages 947-951, October 2009

Interstitial lung disease and sleep: What is known?

Shikhar Agarwal
- Cleveland Clinic, Cleveland, OH, United States
Brittany Richardson
- University of Maryland Baltimore County, Baltimore, MD, United States
Vidya Krishnan
- MetroHealth Medical Center, Cleveland OH, United States
Hartmut Schneider
- Johns Hopkins University School of Medicine, Division of Pulmonary and Critical Care Medicine, 1830 E. Monument Street, 5th Floor Baltimore, MD, United States
Nancy A. Collop
- Johns Hopkins University School of Medicine, Division of Pulmonary and Critical Care Medicine, 1830 E. Monument Street, 5th Floor Baltimore, MD, United States
Sonye K. Danoff
- Johns Hopkins University School of Medicine, Division of Pulmonary and Critical Care Medicine, 1830 E. Monument Street, 5th Floor Baltimore, MD, United States
- Corresponding author. Tel.: +1 410 955 4176; fax: +1 410 614 1652.

Received 31 December 2008; received in revised form 12 January 2009; accepted 16 January 2009.

Abstract

Objectives

Pulmonary fibrosis (PF), a group of disorders characterized by progressive scarring of the lung parenchyma, affects over 500,000 Americans. Fatigue is a common and frequently disabling symptom in PF. We have previously described poor subjective sleep quality in this patient population. We sought to ascertain what is known regarding sleep in PF.

Methods

We reviewed the English language literature for reports on sleep and sleep disorders in patients with PF.

Results

The existing literature is small and heterogeneous with regard to inclusion criteria. There are a number of distinctive changes in sleep architecture associated with PF including decreased REM sleep and increased sleep fragmentation. In addition, there is suggestion of possible sleep disturbances in this population including OSA, although the frequency of such sleep abnormalities as well as predictors of these abnormalities remain uncertain.

Conclusions

There is significant need for larger studies characterizing sleep in patients with defined PF. These studies are particularly critical given the limited options for therapy in patients with PF and the impact of fatigue in this disorder.

Keywords: Idiopathic pulmonary fibrosis, Obstructive sleep apnea, Sleep quality, Fatigue, Sleep architecture, Nocturnal oxygen desaturation