Top

Published in:

Open Access 01-06-2021 | Cystic Fibrosis | Sleep Breathing Physiology and Disorders • Original Article

Association between habitual physical activity (HPA) and sleep quality in patients with cystic fibrosis

Authors: Sarah Dietz-Terjung, Wolfgang Gruber, Sivagurunathan Sutharsan, Christian Taube, Margarete Olivier, Uwe Mellies, Cordula Koerner-Rettberg, Stefanie Dillenhöfer, Florian Stehling, Matthias Welsner

Published in: Sleep and Breathing | Issue 2/2021

Abstract

Purpose

Sleep disturbances and poor sleep quality are known to be present in patients with CF. Regular physical activity plays an important role in the treatment of CF patients due to its positive influence on progression of disease and quality of life. The aim of this work is to create a home-based sleep and activity profile and to investigate the influence of habitual physical activity (HPA) on sleep quality in children, adolescents, and adults with CF.

Methods

A total of 109 CF patients (64 male, mean age 22.7 ± 12.0 years; mean ppFEV1 63.0 ± 26.7) were equipped with an actigraph for a home-based collection of data on sleep and activity over 4 weeks.

Results

Age, FEV1, and BMI affect sleep and activity in CF patients. Especially younger age and higher FEV1 show a great influence on certain aspects of sleep (SE, TST, TIB, WASO, # of awakenings) and activity and its different intensities. General HPA does not affect sleep, but there is a strong correlation between times spent in vigorous to very vigorous intensities and better sleep quality.

Conclusion

Besides younger age and higher FEV1, daily activity in higher intensities influences sleeping behavior of CF patients in a positive way. Patients with poor sleep quality and sleep disturbances possibly benefit from an intensification of physical activity in the home environment.

Trail registration

number: 14–6117-BO (University Duisburg-Essen) and NCT 03518697 (clinical trials).

Elborn JS (2016) Cystic fibrosis. Lancet 388(10059):2519–2531. https://doi.org/10.1016/S0140-6736(16)00576-6CrossRefPubMed

Fauroux B, Pepin J-L, Boelle P-Y, Cracowski C, Murris-Espin M, Nove-Josserand R, Stremler N, Simon T, Burgel PR (2012) Sleep quality and nocturnal hypoxaemia and hypercapnia in children and young adults with cystic fibrosis. Arch Dis Child 97(11):960–966. https://doi.org/10.1136/archdischild-2011-300440CrossRefPubMed

Katz ES (2014) Cystic fibrosis and sleep. Clin Chest Med 35(3):495–504. https://doi.org/10.1016/j.ccm.2014.06.005CrossRefPubMed

Vandeleur M, Walter LM, Armstrong DS, Robinson P, Nixon GM, Horne RSC (2017) What keeps children with cystic fibrosis awake at night? J Cyst Fibros 16:719–726. https://doi.org/10.1016/j.jcf.2017.04.012CrossRefPubMed

Cox NS, Holland AE (2019) Current perspectives of physical activity in cystic fibrosis. Expert Rev Respir Med 13(1):13–22. https://doi.org/10.1080/17476348.2019.1552833CrossRefPubMed

Vendrusculo FM, Heinzmann-Filho JP, da Silva JS et al (2018) Peak Oxygen Uptake and Mortality in Cystic Fibrosis: Systematic Review and Meta-Analysis. In: Peak oxygen uptake and mortality in cystic. Systematic Review and Meta-Analysis. Respir Care, Fibrosis. https://doi.org/10.4187/respcare.06185CrossRef

Schneiderman JE, Wilkes DL, Atenafu EG, Nguyen T, Wells GD, Alarie N, Tullis E, Lands LC, Coates AL, Corey M, Ratjen F (2014) Longitudinal relationship between physical activity and lung health in patients with cystic fibrosis. Eur Respir J 43(3):817–823. https://doi.org/10.1183/09031936.00055513CrossRefPubMed

Hebestreit H, Schmid K, Kieser S, Junge S, Ballmann M, Roth K, Hebestreit A, Schenk T, Schindler C, Posselt HG, Kriemler S (2014) Quality of life is associated with physical activity and fitness in cystic fibrosis. BMC Pulm Med 14:26. https://doi.org/10.1186/1471-2466-14-26CrossRefPubMedPubMedCentral

Cox NS, Pepin V, Holland AE (2019) Greater sleep fragmentation is associated with less physical activity in adults with cystic fibrosis. J Cardiopulm Rehabil Prev 39(1):E11–E14. https://doi.org/10.1097/HCR.0000000000000363CrossRefPubMed

10.

Savi D, Quattrucci S, Internullo M, de Biase RV, Calverley PMA, Palange P (2013) Measuring habitual physical activity in adults with cystic fibrosis. Respir Med 107(12):1888–1894. https://doi.org/10.1016/j.rmed.2013.09.012CrossRefPubMed

11.

Bradley J, O'Neill B, Kent L, Hulzebos EHJ, Arets B, Hebestreit H, Alison J, Arets B, Boas S, Bradley J, Button B, Bye P, Cerny F, Cooper D, Downs AM, Dwyer T, Forster E, Gallagher C, Gruber W, Hebestreit A, Hebestreit H, Huber M, Hulzebos E, Johnstone Z, Lands L, Lannefors L, Lessine F, Lindblad A, Lowman J, Mandrusiak A, Martensson M, McIlwaine M, Möller A, Molloy M, Montgomery G, Morrison L, Murray J, Nippins M, Orenstein D, Prasaad A, Renner S, Salhberg M, Schneiderman JE, Swisher A, Urquhart D, Zeitoun ML (2015) Physical activity assessment in cystic fibrosis: a position statement. J Cyst Fibros 14(6):e25–e32. https://doi.org/10.1016/j.jcf.2015.05.011CrossRefPubMed

12.

de Souza L, Benedito-Silva AA, Pires MLN, Poyares D, Tufik S, Calil HM (2003) Further validation of actigraphy for sleep studies. Sleep 26(1):81–85. https://doi.org/10.1093/sleep/26.1.81CrossRefPubMed

13.

Jean-Louis G, Kripke DF, Cole RJ, Assmus JD, Langer RD (2001) Sleep detection with an accelerometer actigraph: comparisons with polysomnography. Physiol Behav 72(1–2):21–28. https://doi.org/10.1016/S0031-9384(00)00355-3CrossRefPubMed

14.

Jankelowitz L, Reid KJ, Wolfe L, Cullina J, Zee PC, Jain M (2005) Cystic fibrosis patients have poor sleep quality despite normal sleep latency and efficiency. Chest 127(5):1593–1599. https://doi.org/10.1378/chest.127.5.1593CrossRefPubMed

15.

Blackwell T, Redline S, Ancoli-Israel S, Schneider JL, Surovec S, Johnson NL, Cauley JA, Stone KL, Study of Osteoporotic Fractures Research Group (2008) Comparison of sleep parameters from actigraphy and polysomnography in older women: the SOF study. Sleep 31(2):283–291CrossRefPubMedPubMedCentral

16.

Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten C, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J, ATS/ERS Task Force (2005) Standardisation of spirometry. Eur Respir J 26(2):319–338. https://doi.org/10.1183/09031936.05.00034805CrossRefPubMed

17.

Ainsworth BE, Haskell WL, Herrmann SD et al (2011) 2011 compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc 43(8):1575–1581. https://doi.org/10.1249/MSS.0b013e31821ece12CrossRefPubMed

18.

Silva AM, Descalço A, Salgueiro M, Pereira L, Barreto C, Bandeira T, Ferreira R (2016) Respiratory sleep disturbance in children and adolescents with cystic fibrosis. Rev Port Pneumol (2006) 22(4):202–208. https://doi.org/10.1016/j.rppnen.2016.02.007CrossRef

19.

Naqvi SK, Sotelo C, Murry L, Simakajornboon N (2008) Sleep architecture in children and adolescents with cystic fibrosis and the association with severity of lung disease. Sleep Breath 12(1):77–83. https://doi.org/10.1007/s11325-007-0123-0CrossRefPubMed

20.

Vandeleur M, Walter LM, Armstrong DS, Robinson P, Nixon GM, Horne RSC (2017) How well do children with cystic fibrosis sleep? an actigraphic and questionnaire-based study. J Pediatr 182:170–176. https://doi.org/10.1016/j.jpeds.2016.11.069CrossRefPubMed

21.

Ramos RTT, Santana MAP, Almeida PC et al (2013) Nocturnal hypoxemia in children and adolescents with cystic fibrosis. J Bras Pneumol 39(6):667–674. https://doi.org/10.1590/S1806-37132013000600005CrossRefPubMedPubMedCentral

22.

Perin C, Fagondes SC, Casarotto FC, Pinotti AFF, Menna Barreto SS, Dalcin PTR (2012) Sleep findings and predictors of sleep desaturation in adult cystic fibrosis patients. Sleep Breath 16(4):1041–1048. https://doi.org/10.1007/s11325-011-0599-5CrossRefPubMed

23.

Cox NS, Alison JA, Button BM, Wilson JW, Morton JM, Holland AE (2016) Physical activity participation by adults with cystic fibrosis: an observational study. Respirology 21(3):511–518. https://doi.org/10.1111/resp.12719CrossRefPubMed

24.

Spina G, Spruit MA, Alison J, Benzo RP, Calverley PMA, Clarenbach CF, Costello RW, Donaire-Gonzalez D, Dürr S, Garcia-Aymerich J, van Gestel AJR, Gramm M, Hernandes NA, Hill K, Hopkinson NS, Jarreta D, Kohler M, Kirsten AM, Leuppi JD, Magnussen H, Maltais F, Man WDC, McKeough ZJ, Mesquita R, Miedinger D, Pitta F, Singh SJ, Smeenk FWJM, Tal-Singer R, Vagaggini B, Waschki B, Watz H, Wouters EFM, Zogg S, den Brinker AC (2017) Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity. Thorax 72(8):694–701. https://doi.org/10.1136/thoraxjnl-2016-208900CrossRefPubMed

25.

Íscar-Urrutia M, Madrid-Carbajal CJ, Rubinos-Cuadrado G, Fernández-Álvarez R, Vázquez-López MJ, Hernández-González C, Enríquez-Rodríguez AI, García-Clemente M (2018) Objective and subjective sleep efficiency in adult patients with cystic fibrosis and impact on quality of life. Lung 196(6):761–767. https://doi.org/10.1007/s00408-018-0167-xCrossRefPubMed

26.

Bouka A, Tiede H, Liebich L, Dumitrascu R, Hecker C, Reichenberger F, Mayer K, Seeger W, Schulz R (2012) Quality of life in clinically stable adult cystic fibrosis out-patients: associations with daytime sleepiness and sleep quality. Respir Med 106(9):1244–1249. https://doi.org/10.1016/j.rmed.2012.06.010CrossRefPubMed

27.

Cox NS, Alison JA, Holland AE (2013) Interventions for promoting physical activity in people with cystic fibrosis. Cochrane Database Syst Rev 12:CD009448. https://doi.org/10.1002/14651858.CD009448.pub2CrossRef

28.

Moola FJ, Garcia E, Huynh E, Henry L, Penfound S, Consunji-Araneta R, Faulkner GEJ (2017) Physical activity counseling for children with cystic fibrosis. Respir Care 62(11):1466–1473. https://doi.org/10.4187/respcare.05009CrossRefPubMed

29.

Savi D, Di Paolo M, Simmonds N et al (2015) Relationship between daily physical activity and aerobic fitness in adults with cystic fibrosis. BMC Pulm Med 15:59. https://doi.org/10.1186/s12890-015-0036-9CrossRefPubMedPubMedCentral

30.

Hebestreit H, Hulzebos EH, Schneiderman JE et al (2018) Cardiopulmonary exercise testing provides additional prognostic information in cystic fibrosis. Am J Respir Crit Care Med 199:987–995. https://doi.org/10.1164/rccm.201806-1110OCCrossRef

31.

Burtin C, Hebestreit H (2015) Rehabilitation in patients with chronic respiratory disease other than chronic obstructive pulmonary disease: exercise and physical activity interventions in cystic fibrosis and non-cystic fibrosis bronchiectasis. Respiration 89(3):181–189. https://doi.org/10.1159/000375170CrossRefPubMed

32.

Dancey DR, Tullis ED, Heslegrave R, Thornley K, Hanly PJ (2002) Sleep quality and daytime function in adults with cystic fibrosis and severe lung disease. Eur Respir J 19(3):504–510. https://doi.org/10.1183/09031936.02.00088702CrossRefPubMed

33.

Cherobin IA, Dalcin PTR, Ziegler B (2018) Association between lung function, physical activity level and postural evaluation variables in adult patients with cystic fibrosis. Clin Respir J 12(4):1510–1517. https://doi.org/10.1111/crj.12698CrossRefPubMed

34.

Lumertz MS, Pinto LA (2019) Sleep-disordered breathing in cystic fibrosis pediatric subjects. Sleep Sci 12(3):165–170. https://doi.org/10.5935/1984-0063.20190079CrossRefPubMedPubMedCentral

35.

Isaiah A, Daher A, Sharma PB, Naqvi K, Mitchell RB (2019) Predictors of sleep hypoxemia in children with cystic fibrosis. Pediatr Pulmonol 54(3):273–279. https://doi.org/10.1002/ppul.24233CrossRefPubMed

36.

Rasekaba TM, Button BM, Wilson JW, Holland AE (2013) Reduced physical activity associated with work and transport in adults with cystic fibrosis. J Cyst Fibros 12(3):229–233. https://doi.org/10.1016/j.jcf.2012.09.003CrossRefPubMed

37.

Khiroya H, Pound R, Qureshi U, Brown C, Barrett J, Rashid R, Whitehouse JL, Turner AM, Nash EF (2015) Physical activity in adults with cystic fibrosis receiving intravenous antibiotics in hospital and in the community. Open Respir Med J 9:15–21. https://doi.org/10.2174/1874306401509010015CrossRefPubMedPubMedCentral

38.

Britto MT, Garrett JM, Konrad TR, Majure JM, Leigh MW (2000) Comparison of physical activity in adolescents with cystic fibrosis versus age-matched controls. Pediatr Pulmonol 30(2):86–91. https://doi.org/10.1002/1099-0496(200008)30:2<86:AID-PPUL2>3.0.CO;2-ZCrossRefPubMed

Title: Association between habitual physical activity (HPA) and sleep quality in patients with cystic fibrosis
Authors: Sarah Dietz-Terjung
Wolfgang Gruber
Sivagurunathan Sutharsan
Christian Taube
Margarete Olivier
Uwe Mellies
Cordula Koerner-Rettberg
Stefanie Dillenhöfer
Florian Stehling
Matthias Welsner
Publication date: 01-06-2021
Publisher: Springer International Publishing
Keywords: Cystic Fibrosis
Cystic Fibrosis
Published in: Sleep and Breathing / Issue 2/2021
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02130-0

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trail registration

Please log in to get access to this content

Other articles of this Issue 2/2021

Melatonin maintains the function of the blood redox system at combined ethanol-induced toxicity and subclinical inflammation in mice

Prevalence of sleep-disordered breathing and associated risk factors in primary school children in urban and rural environments

Development and psychometric evaluation of the Motivation to Use CPAP Scale (MUC-S) using factorial structure and Rasch analysis among patients with obstructive sleep apnea before CPAP treatment is initiated

Are the International Classification of Functioning, Disability and Health (ICF) domains considered in the obstructive sleep apnea instruments? An integrative review

The effects of continuous positive airway pressure and mandibular advancement therapy on metabolic outcomes of patients with mild obstructive sleep apnea: a randomized controlled study

Propofol versus dexmedetomidine during drug-induced sleep endoscopy (DISE) for pediatric obstructive sleep apnea

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage