Interstitial lung disease and sleep: What is known?

Objectives: Pulmonary fibrosis (PF), a group of disorders characterized by progressive scarring of the lung parenchyma, affects over 500,000 Americans. Fatigue is a common and frequently disabling symptom in PF. We have previously described poor subjective sleep quality in this patient population. We sought to ascertain what is known regarding sleep in PF. Methods: We reviewed the English language literature for reports on sleep and sleep disorders in patients with PF. Results: The existing literature is small and heterogeneous with regard to inclusion criteria. There are a number of distinctive changes in sleep architecture associated with PF including decreased REM sleep and increased sleep fragmentation. In addition, there is suggestion of possible sleep disturbances in this population including OSA, although the frequency of such sleep abnormalities as well as predictors of these abnormalities remain uncertain. Conclusions: There is significant need for larger studies characterizing sleep in patients with defined PF. These studies are particularly critical given the limited options for therapy in patients with PF and the impact of fatigue in this disorder.