Sleep-disordered breathing and Interstitial Lung Disease (ILD)
For this Sleep Science Friday, we dive into another chapter from the ESRS Sleep Medicine Textbook 2nd edition, “Sleep-disordered breathing and interstitial lung disease (ILD)” in the Sleep and Pulmonology section.
The chapter reviews current evidence showing that patients with ILDs, especially idiopathic pulmonary fibrosis (IPF), frequently exhibit disrupted sleep architecture (reduced slow-wave and REM sleep, increased arousals, low sleep efficiency) and a rapid, shallow breathing pattern that persists into sleep and worsens nocturnal hypoxemia.
Post-2002 studies, conducted under updated diagnostic criteria and with modern polysomnography, report a high prevalence of obstructive sleep apnoea (OSA) in ILD populations, often moderate-to-severe, and frequently unrecognised by standard daytime screening tools. Nocturnal oxygen desaturation and untreated OSA correlate with poorer quality of life, greater functional limitation, and reduced survival.
The authors conclude that routine overnight oximetry and, where feasible, full polysomnography should be considered in ILD management to detect treatable sleep-related breathing disturbances. Addressing OSA and nocturnal hypoxaemia may improve symptoms and potentially influence long-term outcomes, even in the absence of definitive therapies for the underlying lung disease.
Keywords:
continuous positive airway pressure (CPAP) therapy, diffuse parenchymal lung diseases, idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnoea (OSA), polysomnography (PSG), sleep apnoea
Key Points:
- Sleep architecture, breathing pattern, and oxygenation parameters during sleep in patients with interstitial lung diseases (ILDs).
- Obstructive sleep apnea (OSA) and ILDs: what is known.
- Pathophysiologic pathways connecting idiopathic pulmonary fibrosis (IPF) and OSA.
- … you can read all key points and the full J.4 Sleep-disordered breathing and interstitial lung disease (ILD) chapter in the ESRS Sleep Medicine Textbook – order it here.
Chapter written by:
Charalampos Mermigkis, Izolde Bouloukaki, Sophia E. Schiza.
Recent publications from ESRS members
-
Stranks L, Abdulsalam M, O’Regan D, Steier J, Hare A. (2025) Acoustics-Derived Home-Based Sleep Study for the Diagnosis of Obstructive Sleep Apnoea in Adults With Intellectual Disabilities: A Feasibility Study. J Intellect Disabil Res.
- Lechat B, Manners J, Pinilla L, Reynolds AC, et al (2025). Global warming may increase the burden of obstructive sleep apnea. Nat Commun
- Jennum P, Debes N, Ibsen R, Ibsen M, Kjellberg J, Svensson J. (2025), Morbidity and mortality from obstructive sleep apnea in children and their parents: a controlled national study. Sleep Med.