First Description of the Hyperpnea–Hypopnea Periodic Breathing in Patients with Interstitial Lung Disease-Obstructive Sleep Apnea: Treatment Implications in a Real-Life Setting

Angelo Canora, Carmine Nicoletta, Giacomo Ghinassi, Dario Bruzzese, Gaetano Rea, Annalisa Capaccio, Sabrina Castaldo, Antonietta Coppola, Giorgio Emanuele Polistina, Alessandro Sanduzzi and Marialuisa Bocchino
Additional contact information
Angelo Canora: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Carmine Nicoletta: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Giacomo Ghinassi: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Dario Bruzzese: Dipartimento di Sanità Pubblica, Università Federico II, 80131 Napoli, Italy
Gaetano Rea: Dipartimento dei Servizi Diagnostici e Generali, Ospedali dei Colli, Monaldi-Cotugno, 80131 Napoli, Italy
Annalisa Capaccio: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Sabrina Castaldo: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Antonietta Coppola: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Giorgio Emanuele Polistina: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Alessandro Sanduzzi: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy
Marialuisa Bocchino: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy

IJERPH, 2019, vol. 16, issue 23, 1-12

Abstract: There is evidence that hypopneas are more common than apneas in obstructive sleep apnea (OSA) related to idiopathic pulmonary fibrosis (IPF). We investigated the frequency distribution of hypopneas in 100 patients with interstitial lung diseases (ILDs) (mean age 69 yrs ± 7.8; 70% males), including 54 IPF cases, screened for OSA by home sleep testing. Fifty age- and sex-matched pure OSA patients were included as controls. In ILD-OSA patients the sleep breathing pattern was characterized by a high prevalence of hypopneas that were preceded by hyperpnea events configuring a sort of periodic pattern. This finding, we arbitrarily defined hyperpnea–hypopnea periodic breathing (HHPB), was likely reflecting a central event and was completely absent in control OSA. Also, the HHPB was highly responsive to oxygen but not to the continuous positive pressure support. Thirty-three ILD-OSA patients (42%) with a HHPB associated with a hypopnea/apnea ratio ≥3 had the best response to oxygen with a median residual AHI of 2.6 (1.8–5.6) vs. 28.3 (20.7–37.8) at baseline ( p < 0.0001). ILD-OSA patients with these characteristics were similarly distributed in IPF (54.5%) and no-IPF cases (45.5%), the most of them being affected by moderate–severe OSA ( p = 0.027). Future studies addressing the pathogenesis and therapy management of the HHPB should be encouraged in ILD-OSA patients.

Keywords: obstructive sleep apnea; idiopathic pulmonary fibrosis; interstitial lung disease; hypopnea; hyperpnea; oxygen (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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