Paediatric origins of adult lung diseases bullet 3: The genesis of adult sleep apnoea in childhood

Objective Obstructive sleep apnea (OSA) are increasingly recognized as important features in diffuse parenchymal lung diseases (DPLDs) with differed prevalence and impact reported. The aim of this study is to systematically review the prevalence of comorbid OSA and characterize its impact on clinical and outcome measurements in adults with DPLDs. Methods Publications addressing the prevalence of OSA in DPLDs and its impacts on DPLDs were selected from electronic databases. A random-effect model was used to estimate the pooled prevalence of OSA. Odds ratios (ORs) or mean differences (MDs) were used to assess the associations of OSA with clinical and outcome measurements. Heterogeneity was quantified by I2 with 95% confidence interval (95% CI). Results 4 studies comprising 643 participants were included. Overall, the pooled prevalence of OSA among DPLDs was 72% (95% CI: 65–79%; I2 = 75.4%). Moderate-severe OSA was observed in 40% patients (95% CI: 28–52%; I2 = 90.8%). The prevalence was higher as 76% in idiopathic pulmonary fibrosis (IPF) patients than in connective tissue associated-ILD or sarcoidosis (60%). Although oxygen desaturation during sleep was greater in OSA group compared with non-OSA patients, there was no difference in lung function or systematic comorbidities between the two groups. The associations between OSA and the mortality or disease progression of DPLDs were also systematically reviewed. Conclusion In conclusion, OSA is a common comorbidity in DPLD patients, affecting approximately three in four patients, which may exacerbate the nocturnal desaturation and have negative influence on the outcomes. Larger studies with more homogeneous samples are warranted.

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Lung Development and Adult Lung Diseases

CHEST Journal ◽

10.1378/chest.06-2663 ◽

2007 ◽

Vol 132 (2) ◽

pp. 651-656 ◽

Cited By ~ 92

Author(s):

Wei Shi ◽

Saverio Bellusci ◽

David Warburton

Keyword(s):

Lung Development ◽

Lung Diseases ◽

Adult Lung

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Respiratory medicine

10.1093/med/9780199230457.003.0018 ◽

2016 ◽

Keyword(s):

Lung Diseases ◽

Cor Pulmonale ◽

Sleep Apnoea ◽

Respiratory Medicine ◽

Chronic Obstructive ◽

Basic Training ◽

Allergic Alveolitis ◽

Obstructive Pulmonary Disease ◽

Obstructive Sleep ◽

Occupational Lung Diseases

Chapter 18 covers the basic science and clinical topics relating to respiratory medicine which trainees are required to learn as part of their basic training and demonstrate in the MRCP. The chapter starts with an introduction to the respiratory system, before covering respiratory defence and physiology, respiratory investigations, respiratory failure, pneumonia, tuberculosis, cystic fibrosis, bronchiectasis, pleural effusion, chronic obstructive pulmonary Disease, adult respiratory distress syndrome, asthma , fungal lung diseases, pulmonary embolism , lung cancer, pulmonary fibrosis, extrinsic allergic alveolitis, occupational lung diseases, sarcoidosis, Cor pulmonale and pulmonary hypertension, pneumothorax, cough and haemoptysis, pulmonary eosinophilia, and obstructive sleep apnoea.

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Comorbidities in interstitial lung diseases

European Respiratory Review ◽

10.1183/16000617.0027-2016 ◽

2017 ◽

Vol 26 (143) ◽

pp. 160027 ◽

Cited By ~ 25

Author(s):

George A. Margaritopoulos ◽

Katerina M. Antoniou ◽

Athol U. Wells

Keyword(s):

Chronic Infection ◽

Lung Diseases ◽

Sleep Apnoea ◽

Interstitial Lung Diseases ◽

Respiratory Status ◽

Appropriate Treatment ◽

Obstructive Sleep ◽

Life Impact ◽

Accurate Treatment

Fibrosing lung disorders include a large number of diseases with diverse behaviour. Patients can die because of the progression of their illness, remain stable or even improve after appropriate treatment has been instituted. Comorbidities, such as acute and chronic infection, gastro-oesophageal reflux, pulmonary hypertension, lung cancer, cardiovascular diseases, and obstructive sleep apnoea, can pre-exist or develop at any time during the course of the disease and, if unidentified and untreated, may impair quality of life, impact upon the respiratory status of the patients, and ultimately lead to disease progression and death. Therefore, early identification and accurate treatment of comorbidities is essential.

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Associations between pediatric asthma and adult lung diseases

10.1183/23120541.lsc-2021.23 ◽

2021 ◽

Author(s):

N Juber ◽

J Liu

Keyword(s):

Lung Diseases ◽

Pediatric Asthma ◽

Adult Lung

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Pulmonary hypertensive vasculopathy in parenchymal lung diseases and/or hypoxia

European Respiratory Review ◽

10.1183/16000617.0003-2017 ◽

2017 ◽

Vol 26 (144) ◽

pp. 170003 ◽

Cited By ~ 4

Author(s):

Maria Rosa Ghigna ◽

Wolter J. Mooi ◽

Katrien Grünberg

Keyword(s):

Lung Disease ◽

Lung Diseases ◽

Chronic Obstructive Lung Disease ◽

Sleep Apnoea ◽

Obstructive Sleep Apnoea Syndrome ◽

Chronic Obstructive ◽

Diffuse Lung Disease ◽

Mean Pulmonary Arterial Pressure ◽

Chronic Lung Diseases ◽

Obstructive Sleep

Pulmonary hypertension (PH) with complicating chronic lung diseases and/or hypoxia falls into group 3 of the updated classification of PH. Patients with chronic obstructive lung disease (COPD), diffuse lung disease (such as idiopathic pulmonary fibrosis (IPF)) and with sleep disordered breathing are particularly exposed to the risk of developing PH. Although PH in such a context is usually mild, a minority of patients exhibit severe haemodynamic impairment, defined by a mean pulmonary arterial pressure (mPAP) of ≥35 mmHg or mPAP values ranging between 25 mmHg and 35 mmHg with a low cardiac index (<2 L·min−1·m−2). The overlap between lung parenchymal disease and PH heavily affects life expectancy in such a patient population and complicates their therapeutic management. In this review we illustrate the pathological features and the underlying pathophysiological mechanisms of pulmonary circulation in chronic lung diseases, with an emphasis on COPD, IPF and obstructive sleep apnoea syndrome.

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