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. 2001 Jun;56(6):482–486. doi: 10.1136/thorax.56.6.482

A survey of nocturnal hypoxaemia and health related quality of life in patients with cryptogenic fibrosing alveolitis

M Clark 1, B Cooper 1, S Singh 1, M Cooper 1, A Carr 1, R Hubbard 1
PMCID: PMC1746078  PMID: 11359966

Abstract

BACKGROUND—A survey of overnight oximetry was conducted to estimate the prevalence of nocturnal hypoxaemia in patients with cryptogenic fibrosing alveolitis and to establish whether nocturnal hypoxaemia is related to quality of life.
METHODS—All patients with cryptogenic fibrosing alveolitis attending Nottingham City Hospital were invited to enter the study. Spirometric measurements and capillary blood gas tensions were obtained and overnight oxygen saturation was recorded at home. Quality of life was assessed using the Short Form-36, Chronic Respiratory Questionnaire, Hospital Anxiety Depression Scale, and Epworth Sleepiness Score questionnaires.
RESULTS—Sixty seven eligible patients were identified and 50 agreed to enter the study, although two were subsequently excluded because they already used oxygen overnight. In the remaining 48 the mean (SD) overnight oxygen saturation (SaO2) was 92.5 (4.3)% and the median number of dips greater than 4% per hour was 2.3 (interquartile range 1.5-5.3). Daytime oxygen level predicted mean overnight SaO2 (1.94%/kPa, 95% CI 1.22 to 2.66, p<0.001) but percentage predicted forced vital capacity (FVC) did not (0.018%/% predicted FVC, 95% CI -0.04 to 0.08, p=0.5). Nocturnal hypoxaemia was associated with decreased energy levels and impaired daytime social and physical functioning, and these effects were independent of FVC.
CONCLUSIONS—Nocturnal hypoxaemia is common in patients with cryptogenic fibrosing alveolitis and may have an impact on health related quality of life.



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Selected References

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  1. Bye P. T., Issa F., Berthon-Jones M., Sullivan C. E. Studies of oxygenation during sleep in patients with interstitial lung disease. Am Rev Respir Dis. 1984 Jan;129(1):27–32. doi: 10.1164/arrd.1984.129.1.27. [DOI] [PubMed] [Google Scholar]
  2. Cormick W., Olson L. G., Hensley M. J., Saunders N. A. Nocturnal hypoxaemia and quality of sleep in patients with chronic obstructive lung disease. Thorax. 1986 Nov;41(11):846–854. doi: 10.1136/thx.41.11.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Douglas N. J., Flenley D. C. Breathing during sleep in patients with obstructive lung disease. Am Rev Respir Dis. 1990 Apr;141(4 Pt 1):1055–1070. doi: 10.1164/ajrccm/141.4_Pt_1.1055. [DOI] [PubMed] [Google Scholar]
  4. Guyatt G. H., Berman L. B., Townsend M., Pugsley S. O., Chambers L. W. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987 Oct;42(10):773–778. doi: 10.1136/thx.42.10.773. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hubbard R., Johnston I., Britton J. Survival in patients with cryptogenic fibrosing alveolitis: a population-based cohort study. Chest. 1998 Feb;113(2):396–400. doi: 10.1378/chest.113.2.396. [DOI] [PubMed] [Google Scholar]
  6. Hubbard R., Lewis S., Richards K., Johnston I., Britton J. Occupational exposure to metal or wood dust and aetiology of cryptogenic fibrosing alveolitis. Lancet. 1996 Feb 3;347(8997):284–289. doi: 10.1016/s0140-6736(96)90465-1. [DOI] [PubMed] [Google Scholar]
  7. Hubbard R., Venn A., Lewis S., Britton J. Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am J Respir Crit Care Med. 2000 Jan;161(1):5–8. doi: 10.1164/ajrccm.161.1.9906062. [DOI] [PubMed] [Google Scholar]
  8. Johns M. W. Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest. 1993 Jan;103(1):30–36. doi: 10.1378/chest.103.1.30. [DOI] [PubMed] [Google Scholar]
  9. Johnson M. A., Kwan S., Snell N. J., Nunn A. J., Darbyshire J. H., Turner-Warwick M. Randomised controlled trial comparing prednisolone alone with cyclophosphamide and low dose prednisolone in combination in cryptogenic fibrosing alveolitis. Thorax. 1989 Apr;44(4):280–288. doi: 10.1136/thx.44.4.280. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Johnston I. D., Gomm S. A., Kalra S., Woodcock A. A., Evans C. C., Hind C. R. The management of cryptogenic fibrosing alveolitis in three regions of the United Kingdom. Eur Respir J. 1993 Jun;6(6):891–893. [PubMed] [Google Scholar]
  11. Panos R. J., Mortenson R. L., Niccoli S. A., King T. E., Jr Clinical deterioration in patients with idiopathic pulmonary fibrosis: causes and assessment. Am J Med. 1990 Apr;88(4):396–404. doi: 10.1016/0002-9343(90)90495-y. [DOI] [PubMed] [Google Scholar]
  12. Perez-Padilla R., West P., Lertzman M., Kryger M. H. Breathing during sleep in patients with interstitial lung disease. Am Rev Respir Dis. 1985 Aug;132(2):224–229. doi: 10.1164/arrd.1985.132.2.224. [DOI] [PubMed] [Google Scholar]
  13. Raghu G., Depaso W. J., Cain K., Hammar S. P., Wetzel C. E., Dreis D. F., Hutchinson J., Pardee N. E., Winterbauer R. H. Azathioprine combined with prednisone in the treatment of idiopathic pulmonary fibrosis: a prospective double-blind, randomized, placebo-controlled clinical trial. Am Rev Respir Dis. 1991 Aug;144(2):291–296. doi: 10.1164/ajrccm/144.2.291. [DOI] [PubMed] [Google Scholar]
  14. Schnabel A., Reuter M., Csernok E., Richter C., Gross W. L. Subclinical alveolar bleeding in pulmonary vasculitides: correlation with indices of disease activity. Eur Respir J. 1999 Jul;14(1):118–124. doi: 10.1034/j.1399-3003.1999.14a20.x. [DOI] [PubMed] [Google Scholar]
  15. Swinburn C. R., Mould H., Stone T. N., Corris P. A., Gibson G. J. Symptomatic benefit of supplemental oxygen in hypoxemic patients with chronic lung disease. Am Rev Respir Dis. 1991 May;143(5 Pt 1):913–915. doi: 10.1164/ajrccm/143.5_Pt_1.913. [DOI] [PubMed] [Google Scholar]
  16. Turner-Warwick M., Burrows B., Johnson A. Cryptogenic fibrosing alveolitis: clinical features and their influence on survival. Thorax. 1980 Mar;35(3):171–180. doi: 10.1136/thx.35.3.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Turner-Warwick M., Burrows B., Johnson A. Cryptogenic fibrosing alveolitis: response to corticosteroid treatment and its effect on survival. Thorax. 1980 Aug;35(8):593–599. doi: 10.1136/thx.35.8.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Turner-Warwick M., Lebowitz M., Burrows B., Johnson A. Cryptogenic fibrosing alveolitis and lung cancer. Thorax. 1980 Jul;35(7):496–499. doi: 10.1136/thx.35.7.496. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

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