# Evaluating Obstructive Sleep Apnea Utilizing Arterial Tonometry in Individuals with Cystic Fibrosis

## TL;DR

This study found that obstructive sleep apnea is more common in adults with cystic fibrosis than expected, and traditional screening tools may not work well for this group.

## Contribution

The study is the first to evaluate OSA prevalence in cystic fibrosis patients using PAT-based home sleep testing and assess the effectiveness of traditional screening tools in this population.

## Key findings

- Home sleep apnea testing using PAT identified a higher-than-expected prevalence of OSA in adults with cystic fibrosis.
- Traditional OSA screening tools like STOP-Bang, ESS, and PSQI did not correlate with OSA diagnosis in this cohort.
- CF-specific sleep screening tools may be needed due to lack of correlation between OSA and standard sleep questionnaires.

## Abstract

What are the main findings?
Home sleep apnea testing using peripheral arterial tonometry (PAT) identified a higher-than-expected prevalence of obstructive sleep apnea (OSA) in adults with cystic fibrosis (CF).Traditional OSA screening tools (e.g., STOP-Bang, ESS, PSQI) did not correlate with OSA diagnosis in this cohort of adults with CF.

Home sleep apnea testing using peripheral arterial tonometry (PAT) identified a higher-than-expected prevalence of obstructive sleep apnea (OSA) in adults with cystic fibrosis (CF).

Traditional OSA screening tools (e.g., STOP-Bang, ESS, PSQI) did not correlate with OSA diagnosis in this cohort of adults with CF.

What is the implication of the main finding?
Individuals with CF, especially those with reduced lung function or higher Mallampati scores, may be underdiagnosed for OSA.PAT-based home sleep testing may be a feasible, low-burden alternative to polysomnography for sleep evaluation in CF.

Individuals with CF, especially those with reduced lung function or higher Mallampati scores, may be underdiagnosed for OSA.

PAT-based home sleep testing may be a feasible, low-burden alternative to polysomnography for sleep evaluation in CF.

Poor sleep quality and excessive daytime sleepiness are commonly reported by individuals with cystic fibrosis. The potential impact of comorbid sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA), has not been extensively studied in the CF population. At present, there are no specific recommendations available to help clinicians identify patients with CF who are at increased risk of sleep disorders. Home sleep apnea testing using a validated peripheral arterial tonometry (PAT) device may offer an accurate diagnosis of OSA in a more convenient and low-cost method than in-lab polysomnography. In this single-center study of 19 adults with CF, we found an increased prevalence of OSA among individuals with CF compared to general population estimates. Although associations with an FEV < 70% predicted and a modified Mallampati score ≥ 3 were observed, these odds ratios did not reach statistical significance, likely reflecting limited power in this small pilot sample. There was no association found between the self-reported presence of nocturnal cough or snoring and OSA. We also found no association between OSA and abnormal scores on commonly used, validated sleep questionnaires, suggesting that CF-specific scales may be needed for effective screening in the CF clinic.