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Abstract
BACKGROUND: Both nasal obstruction and sleep disturbance are common in patients with cystic fibrosis (CF). In patients with obstructive sleep apnea (OSA), studies suggest that these conditions are related and that nasal congestion improves with CPAP therapy. We hypothesized that subjects admitted to hospital for therapy of an exacerbation of CF would have both nasal symptoms and sleep disturbance and that these would improve with the initiation of nocturnal high-flow nasal cannula therapy (HFNC).
METHODS: Twenty-five subjects with an exacerbation of CF were enrolled to randomly receive either 5 d of nocturnal HFNC at 20 L/min in the treatment group or 5 L/min of nocturnal nasal cannula air at ambient temperature and humidity in the low-flow group. On the first and last day of the study, the Sino-Nasal Outcome Test (SNOT-20) was administered to evaluate nasal symptoms, and sleep quality was measured using the Actiwatch 2.
RESULTS: Fifteen subjects completed the study (6 HFNC, 9 low flow). We confirmed that subjects had significant sleep disturbance that did not improve over the 5 d of the study. Subjects also had disturbing nasal symptoms that significantly improved only in those receiving HFNC (pre 14 [20] vs post 6 [13], P = .027).
CONCLUSIONS: Similar to what has been reported in older subjects with OSA, nocturnal HFNC improves sinonasal symptoms in subjects with an exacerbation of CF. There was no measurable effect on sleep quality, which may be due to the short duration of the study, or to subjects being evaluated while being treated in a hospital setting.
Footnotes
- Correspondence: Michael D Davis RRT PhD FAARC, Wells Center for Pediatric Research, Pulmonology, Allergy, and Sleep Medicine, Riley Hospital for Children at Indiana University, 1044 W. Walnut Street R4-472, Indianapolis, IN 46202. E-mail: mdd1{at}iu.edu
Dr Davis is funded by NIH/NHLBI PO1 HL128192 and the Indiana CTSI UL 1 TR002529. Dr Davis is a patent holder of Optate. Dr Davis discloses a relationship with Airbase Breathing Company. The remaining authors have disclosed no conflicts of interest.
This study was funded by Fisher & Paykel. The sponsor had no role in the design of the study, the conduct of the study, analysis of the data, or the writing of the manuscript.
- Copyright © 2023 by Daedalus Enterprises
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