Sleep disordered breathing and sleep quality of children with bronchiolitis obliterans

Bronchiolitis obliterans (BO) is characterized by persistent symptoms of obstructive lung disease following acute bronchial injury. There are few data on long-term follow-up, frequency of sleep disordered breathing and sleep quality of BO patients. Our aim was to evaluate clinical findings, frequency of sleep disordered breathing and sleep quality of BO patients. Fifty-two postinfectious BO patients (73% male) (mean age: 86±65 months) followed for 35±31 months in three different centres were enrolled. Mean age at diagnosis was 35±31 months. 42% of the patients had a history of hospitalization in an intensive care unit, 11.5% had immunodeficiency, 36.5% had gastroesophageal reflux, 3.8% had pulmonary hypertension. Mean FEV1 was 52.,8%±13.2, FVC was 61,7±11,1% in 24 patients who could perform pulmonary function test (PFT). 96% of patients were receiving inhaled/nebulised steroid, 75% short-acting bronchodilators, 17.3% long-acting bronchodilators, 7.7% systemic steroids, 9.6% long-term macrolide treatment. Three patients with hypoxia were on home oxygen therapy, two patients with hypercapnic respiratory failure were using noninvasive machanical ventilation. According to Pediatric Sleep Questionnaire; 32.7% of patients had sleep disordered breathing (Mean score: 0,26±0,16). Pittsburgh Sleep Quality Index (PSQI) was performed in 31 patients who were older than 4 years (Mean PSQI global score: 4,2±3,6). According to PSQI, 42% of patients had poor sleep quality. There were no significant relationship between sleep quality and symptoms and PFT results (p>0.05). Sleep disordered breathing and poor sleep quality are common in BO patients.