A little boy with cystic fibrosis wearing a nasal cannula furrows his brows in unrest while trying to sleep in his bed.

Sleep Issues and Cystic Fibrosis

Last updated: March 2022

Getting enough sleep is important to maintain health for anyone, but especially someone with a chronic disease or health issue. When you sleep, the body helps to support healthy brain function and works to restore the body. For children and teens, sleep even helps support growth and development.1

Individuals with cystic fibrosis (CF) may have sleep problems due to abnormalities with the airway, as well as impaired gas exchange.2 CF has also been shown to predispose individuals to hypoxemia, or low levels of oxygen in the blood, which is associated with sleep disruption and daytime impairment.3 It’s important, then, to be aware of the various sleep issues that can arise with CF and what can be done in order to promote the best quality of sleep possible.

Why is sleep important?

Sleep plays a role in physical and mental health. Without adequate or enough sleep, illness can develop or worsen. Adequate sleep helps to:1

  • Repair the heart and blood vessels
  • Maintain a healthy balance of hormones, especially those involved with feeling full, like leptin and ghrelin
  • Maintain how the body responds to insulin
  • Promote growth and development
  • Maintain the immune system and helps fight infection
  • Aid with concentration, focus, and productivity at work or school

CF children and sleep

Good, restorative sleep is especially important for children. Children with CF often get less sleep and have more sleep disruptions than children without CF, even when the disease was stable and well-controlled.4 The children with CF in the study had overall lower total sleep time and sleep quality than those who did not have CF, and they also had a higher rate of sleep apnea, which can cause multiple awakenings during the night, as well as a less restful sleep.4

During episodes of worsening CF, sleep may be further disturbed with nebulizer treatments or coughing. When children don’t get enough sleep, this can affect mood, quality of life, concentration, and behavior – and in children with CF, this may be especially so – not to mention the effect on overall health. More research needs to be done to see how, specifically, sleep deprivation and sleep issues affect children with CF, as well as what can be done to help ameliorate this.

CF Adults and sleep

Getting adequate sleep is important for day-to-day functioning, as well as maintaining performance at school or work. Adults with CF also have impaired sleep, which can have negative effects on other areas of life. Individuals with CF tend to have more fragmented sleep and worse sleep quality than those without CF, with more variability night-to-night.2 Self-perceived quality of sleep was also worse in those with CF than those without CF.2

Causes for sleep disruption may include cough, hypoxemia, medication side effects, and increased work of breathing.3 Adults showed more daytime hypoxemia, which may then also carry over to a restless night.3 Despite this, oxygen supplementation has not been shown to improve sleep quality in those with CF.3 More research needs to be done on the relationship between CF severity and how this impacts sleep quality and sleep issues.

Further exploration needed

Despite studies on the sleep issues found for those with CF, there aren’t many options for treatment, which is frustrating for many patients.5 Sleep deprivation can increase the risk of infection because of a weakened immune system, which is a primary concern for those with CF. The lack of studies and interventions, especially for pediatric patients, is something that needs to be further explored in order to better help these populations.

Talk with your doctor and treatment team about your sleep habits and any issues you might be experiencing that may be related to sleep deprivation. Things like maintaining a regular sleep/wake routine, eliminating distractions, limiting caffeine, and making sure your CF is controlled may be beneficial. A sleep medicine specialist might also be worth adding to the treatment team and may provide additional insight.

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