Prevalence and prognostic significance of obstructive sleep apnea in patients with idiopathic pulmonary fibrosis: A prospective cohort study

Vollständiger Abstract

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ABSTRACT BACKGROUND: Obstructive sleep apnea (OSA) is a recognized comorbidity in idiopathic pulmonary fibrosis (IPF); however, its true prevalence remains uncertain, and its prognostic implications have not been fully elucidated. This study aimed to determine the prevalence of and risk factors for OSA in patients with IPF and to evaluate its impact on disease progression. METHODS: This prospective study enrolled 50 patients with IPF followed at a tertiary care center. All patients underwent polysomnography (PSG), and OSA was classified as mild, moderate, or severe. The Berlin Questionnaire and the Epworth Sleepiness Scale were administered prior to PSG. Forced vital capacity (FVC) and diffusing capacity of the lung for carbon monoxide (DLCO) were measured at baseline and at 1 year. Disease progression was defined as a ≥10% decline in FVC and/or a ≥15% decline in DLCO. RESULTS: The mean age was 67.8 ± 6.7 years, and 80% were male. OSA prevalence was 90.0% (95% confidence interval: 78.2–96.7), with mild, moderate, and severe disease each present in 30% of patients. Moderate-to-severe OSA was associated with significantly greater pulmonary function decline ( P = 0.030). Hypertension and high-risk status on the Berlin Questionnaire were significantly associated with the presence of OSA. CONCLUSIONS: OSA prevalence in IPF is remarkably high, with the majority having moderate-to-severe disease. The Berlin Questionnaire may serve as a reliable screening tool for PSG candidacy in this population. These findings suggest that OSA may contribute to functional disease progression in patients with IPF.