Breathing Illnesses

Breathing Illnesses: An Overview

Sleep-Disordered Breathing and Chronic Respiratory Infections

Prevalence and Impact of Sleep-Disordered Breathing (SDB)

Sleep-disordered breathing (SDB) encompasses various conditions characterized by abnormal respiratory patterns during sleep, such as obstructive sleep apnea. SDB is notably prevalent among patients with chronic respiratory infections, including cystic fibrosis (CF), bronchiectasis, and mycobacterial infections. In patients with bronchiectasis, SDB affects approximately 50% of individuals, particularly those with severe disease or comorbidities like chronic obstructive pulmonary disease (COPD) and primary ciliary dyskinesia. SDB also complicates the clinical course of both children and adults with CF, impacting their quality of life and disease prognosis.

Pathophysiological Mechanisms

Common mechanisms underlying SDB in chronic respiratory infections include inflammation, chronic nocturnal cough, excessive mucous production, and upper airway involvement. These factors contribute to the onset and severity of SDB, necessitating routine assessment in clinical evaluations to avoid late diagnosis.

Prevalence of Sleep-Disordered Breathing in the General Population

Findings from the HypnoLaus Study

The HypnoLaus study assessed the prevalence of SDB in a large population-based sample in Lausanne, Switzerland. The study found that moderate-to-severe SDB (≥15 events per hour) was present in 23.4% of women and 49.7% of men. The high prevalence is attributed to improved recording techniques and new criteria for defining respiratory events. SDB was independently associated with hypertension, diabetes, metabolic syndrome, and depression, highlighting its significant public health implications.

Psychological Comorbidity in Respiratory Illness

Psychological Aspects and Functional Disorders

Respiratory illnesses often have psychological comorbidities, including conditions like wheeze and cough, which can present as respiratory morbidity. These functional disorders are similar in both pediatric and adult populations, emphasizing the need for comprehensive management approaches that address both physical and psychological aspects of respiratory illnesses.

Respiratory Health in Athletes

Systematic Assessment in Illness-Susceptible Athletes

Respiratory tract illnesses are a leading cause of time loss in training and competition among elite athletes. A systematic assessment of respiratory health in athletes revealed that 80% had at least one respiratory health issue requiring intervention, with sinonasal problems being the most common. The study identified two main clusters of respiratory health issues: asthma, sinus problems, and allergy; and laryngeal and breathing pattern dysfunction. This systematic approach is crucial for identifying and managing respiratory problems in athletes.

Dysfunctional Breathing in Children and Adolescents

Prevalence and Management

Dysfunctional breathing, including hyperventilation syndrome and vocal cord dysfunction, affects about 10% of the general population and is associated with symptoms like dyspnea and chest tightness. In children with asthma, dysfunctional breathing is linked to poorer asthma control. Despite its prevalence, there is a lack of controlled clinical trials evaluating treatment for these disorders in children, underscoring the need for well-designed studies to inform clinical practice .

Internet-Based Interventions for Chronic Respiratory Conditions

Breathe Easier Online (BEO) Program

The Breathe Easier Online (BEO) program is an internet-based intervention aimed at improving psychosocial well-being in children and adolescents with chronic respiratory conditions. A pilot trial showed that participants in the BEO group reported significantly lower depression and improved attitudes toward their illness compared to baseline, suggesting the potential efficacy of such interventions in enhancing the well-being of young patients with chronic respiratory conditions.

Conclusion

Breathing illnesses, including sleep-disordered breathing, dysfunctional breathing, and chronic respiratory conditions, have significant impacts on various populations, from patients with chronic infections to elite athletes and children. Comprehensive assessment and management strategies, including psychological support and innovative interventions like internet-based programs, are essential for improving outcomes and quality of life for individuals affected by these conditions.

Summary

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