<p><strong>Abstract</strong></p><p><strong>Background:</strong> Obstructive Sleep Apnea Syndrome (OSAS) is prevalent and the syndrome is associated with increased risk of health related problems. A positive effect of behavioral change programs to reduce weight is expected. More research is needed to identify barriers and facilitators to behavior change.</p><p><strong>Aim:</strong> To identify prerequisites for eating behavior change in obese patients with OSAS.</p><p><strong>Method:</strong> Semi-structured interviews were conducted on 15 obese patients living with OSAS. Data were analyzed using qualitative content analysis.</p><p><strong>Result:</strong> The categories identified as barriers to change in eating behavior in the analysis were desire and craving, influenced by mental state, low self-confidence, insufficient support, social acceptance, complexity of coping with new eating behaviors in daily routines, costs, lack of knowledge, perceived helplessness and low susceptibility. Categories that were identified as facilitators to change in eating behavior were high value of outcome expectations, support and control, external premises, applicable behavior change strategies, self-worth and being triggered by weight increase.</p><p><strong> Conclusion:</strong> To motivate patients living with OSAS to change their eating behavior it is necessary to address both barriers and facilitators. The categories low susceptibility as a barrier and high value of outcome expectations as a facilitator appears to be important for this patient group.</p> / <p><strong>Sammanfattning</strong></p><p><strong>Bakgrund:</strong> Obstruktiv sömnapnésyndrom (OSAS) är vanligt förekommande och syndromet är associerat med hälsorelaterade problem. Det finns en förväntad positiv effekt av beteende förändrande interventioner som syftar på viktminskning. Mera forskning behövs för att identifiera hinder och underlättande faktorer.</p><p><strong>Syfte:</strong> Att identifiera förutsättningar för att ändra matvanor hos feta patienter med OSAS.</p><p><strong>Metod:</strong> Semistrukturerade intervjuer utfördes på 15 feta patienter med OSAS och kategorier identifierades med hjälp av en innehållsanalys.</p><p><strong>Resultat:</strong> Följande kategorier identifierades de som hinder till förändrade matvanor i analysen; begär och sug, påverkan av sinnestillstånd, lågt självförtroende, otillräcklig stöd, social acceptans, komplexiteten i att klara av nya beteenden i dagliga rutiner, kostnader, brist på kunskap, upplevd hjälplöshet och låg mottaglighet. De kategorier som underlättade ändrade matvanor i studien var följande: högt värde av förväntningar, stöd och kontroll, externa faktorer, användbara strategier för ändringar i beteende, självkänsla och viktökning som utlösare.</p><p><strong>Slutsats:</strong> För att framgångsrikt motivera patienter med OSAS att ändra sina matvanor måste hänsyn tas både till hinder och till faktorer som underlättar ett förändrat beteende. Kategorierna ”låg mottaglighet” som ett hinder och ” högt värde av förväntningar” som underlättande faktor tycks vara viktiga för denna patientgrupp.</p>

Abstract Background: Obstructive Sleep Apnea Syndrome (OSAS) is prevalent and the syndrome is associated with increased risk of health related problems. A positive effect of behavioral change programs to reduce weight is expected. More research is needed to identify barriers and facilitators to behavior change. Aim: To identify prerequisites for eating behavior change in obese patients with OSAS. Method: Semi-structured interviews were conducted on 15 obese patients living with OSAS. Data were analyzed using qualitative content analysis. Result: The categories identified as barriers to change in eating behavior in the analysis were desire and craving, influenced by mental state, low self-confidence, insufficient support, social acceptance, complexity of coping with new eating behaviors in daily routines, costs, lack of knowledge, perceived helplessness and low susceptibility. Categories that were identified as facilitators to change in eating behavior were high value of outcome expectations, support and control, external premises, applicable behavior change strategies, self-worth and being triggered by weight increase. Conclusion: To motivate patients living with OSAS to change their eating behavior it is necessary to address both barriers and facilitators. The categories low susceptibility as a barrier and high value of outcome expectations as a facilitator appears to be important for this patient group. / Sammanfattning Bakgrund: Obstruktiv sömnapnésyndrom (OSAS) är vanligt förekommande och syndromet är associerat med hälsorelaterade problem. Det finns en förväntad positiv effekt av beteende förändrande interventioner som syftar på viktminskning. Mera forskning behövs för att identifiera hinder och underlättande faktorer. Syfte: Att identifiera förutsättningar för att ändra matvanor hos feta patienter med OSAS. Metod: Semistrukturerade intervjuer utfördes på 15 feta patienter med OSAS och kategorier identifierades med hjälp av en innehållsanalys. Resultat: Följande kategorier identifierades de som hinder till förändrade matvanor i analysen; begär och sug, påverkan av sinnestillstånd, lågt självförtroende, otillräcklig stöd, social acceptans, komplexiteten i att klara av nya beteenden i dagliga rutiner, kostnader, brist på kunskap, upplevd hjälplöshet och låg mottaglighet. De kategorier som underlättade ändrade matvanor i studien var följande: högt värde av förväntningar, stöd och kontroll, externa faktorer, användbara strategier för ändringar i beteende, självkänsla och viktökning som utlösare. Slutsats: För att framgångsrikt motivera patienter med OSAS att ändra sina matvanor måste hänsyn tas både till hinder och till faktorer som underlättar ett förändrat beteende. Kategorierna ”låg mottaglighet” som ett hinder och ” högt värde av förväntningar” som underlättande faktor tycks vara viktiga för denna patientgrupp.

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Αντικείμενο της παρούσας διπλωματικής εργασίας είναι η ανάπτυξη εφαρμογής για λειτουργικό σύστημα Android, για την ανίχνευση της υπνικής άπνοιας. Αρχικά μελετάται η υπνική άπνοια σαν υπνική διαταραχή, οι διάφορες κατηγορίες της, συμπτώματά της και οι τρόποι θεραπείας της. Στη συνέχεια γίνεται αναφορά στις φορητές ηλεκτρονικές συσκευές για τη διάγνωση αυτής της ασθένειας καθώς και τα βασικά κριτήρια που πρέπει να πληρούν οι συσκευές αυτές, όπως αυτά διαμορφώθηκαν από διεθνείς οργανισμούς που ασχολούνται με την μελέτη των ασθενειών του ύπνου. Έπειτα παρουσιάζεται το λειτουργικό σύστημα Android, αναλύεται η αρχιτεκτονική του καθώς και η αρχιτεκτονική των εφαρμογών που Η υπνική άπνοιααναπτύσσονται για αυτό το λογισμικό. Παρουσιάζεται η πλατφόρμα ανάπτυξης Eclipse καθώς και οι επιπρόσθετες δυνατότητες που αποκτά με την προσθήκη του πακέτου Android SDK. Τέλος παρουσιάζονται βασικά παραδείγματα εφαρμογών ώστε να μπορεί ο αναγνώστης να εξοικειωθεί με βασικές δομές που χρησιμοποιήθηκαν για την ανάπτυξη της παρούσας εφαρμογής. Παρουσιάζεται επίσης η λογική της εφαρμογής που αναπτύχθηκε. Βασικές αρχές για την ψηφιακή επεξεργασία σήματος όπως αυτές χρησιμοποιήθηκαν για την επεξεργασία του σήματος της αναπνοής που αναλύεται αυτόματα από την εφαρμογή και τέλος ο μηχανισμός εξαγωγής του τελικού συμπεράσματος, δηλαδή ο τρόπος με τον οποίο η εφαρμογή πραγματοποιεί την τελική της διάγνωση. / The subject of this diploma thesis is the development of an Android application, which is capable to diagnose sleeping apnea. Firstly, there is an extended presentation of sleeping apnea as a sleep disorder. The categories in which sleeping apnea can be divided. Its symptoms and the ways of healing this disorder. Moreover, portable devices for the diagnosis of this disorder are been represented and referred the goals that these devices have to achieve, as they formed by international organizations, which are occupied with the analysis of sleeping disorders. Then the operating system Android is been analyzed, in the domain of its architecture and the structure of an Android application. Furthermore, eclipse IDE is been represented and the further capabilities that it is gain with the installation of the Android SDK. In the last section of this diploma thesis there are some basic example application, which help the primer to acquaint with the structure that are used in the main program of developed application.

Le syndrome d’apnées obstructives du sommeil (SAOS) affecte 5 à 20% de la population générale et est associée à des complications cardiovasculaires, ce qui en fait un véritable problème de santé publique. Les épisodes itératifs d’obstruction pharyngée nocturne qui le caractérisent aboutissent à une hypoxie intermittente, elle-même impliquée dans ces complications cardiovasculaires. A ce jour, les mécanismes reliant SAOS et athérosclérose restent méconnus. De plus, le traitement de référence du SAOS par pression positive continue présente dans certaines populations une efficacité limitée sur les conséquences cardiovasculaires du SAOS, d’où la nécessité de développer de nouvelles thérapeutiques ciblant spécifiquement le processus athéromateux. Des perturbations du métabolisme de l’acide arachidonique à l’origine de la synthèse d’eicosanoïdes pro-inflammatoires ont déjà été décrites au cours du SAOS et ont été associées au processus athéromateux. Le but de ce travail a donc été de préciser par une approche translationnelle le rôle de certains de ces eicosanoïdes, à savoir le thromboxane A2 et les cystéinyl-leucotriènes dans l’athérogénèse associée au SAOS et de les évaluer en tant que potentielles cibles thérapeutiques. Ces travaux ont montré non seulement une activation des voies métaboliques du thromboxane A2 et des cystéinyl-leucotriènes au cours du SAOS, mais également leur association avec le processus athéromateux. Enfin, des traitements pharmacologiques ciblant spécifiquement ces médiateurs étaient capables de ralentir la progression de l’athérosclérose en lien avec le SAOS dans un modèle murin de SAOS. Ces travaux démontrent donc le rôle du thromboxane A2 et des cystéinyl-leucotriènes dans l’athérosclérose associée au SAOS, et positionnent ces deux voies métaboliques comme des cibles thérapeutiques potentielles pour traiter les conséquences cardiovasculaires du SAOS. / Obstructive sleep apnea (OSA) is a really public health problem since it affects 5 to 20% of general population and is associated with increased cardiovascular morbidity and mortality. Repetitive nocturnal pharyngeal obstruction leads to intermittent hypoxia, which is responsible of premature atherosclerosis and also cardiovascular complications.Nevertheless, mechanims linking OSA and atherosclerosis remains poorly understood. In addition, continuous positive airway pressure (CPAP) application, which is the gold standard treatment of OSA, has poor effect on OSA cardiovascular consequences in some populations, highlighting the need of alternative therapeutic strategies. Alterations of several eicosanoids resulting to arachidonate metabolism had already been described during OSA, these latter being associated with vascular remodeling. The aim of this work was to precise trough a translational approach the contribution of some eicosanoids, especially thromboxane A2 and cysteinyl-leukotriene on OSA related-atherogenesis and also to evaluate these latter as therapeutic target.We had shown an activation of both thromboxane A2 and cysteinyl-leukotriene pathways in OSA, this latter being associated with vascular remodeling. In addition, pharmacological treatment by cyclooxygenase type 1 inhibitor or CysLT1 receptor antagonist reduced OSA-related atherosclerosis progression in an OSA mouse model.Finally, these works had demonstrated the implication of both thromboxane A2 and cysteinyl-leukotrienes activation in OSA-related atherosclerosis, but also the potential therapeutic of these targets to treat cardiovascular consequences of OSA.

Título: Estresse oxidativo e hormônios esteróides na associação entre Distúrbios Respiratórios do Sono e Doença Aterosclerótica Coronariana Introdução: Estudos epidemiológicos mostram a existência de associação entre a Doença Aterosclerótica Coronariana (DAC) e os Distúrbios Respiratórios do Sono (DRS). Evidencias sugerem que o estresse oxidativo gerado pela hipóxia intermitente sofrida pelos pacientes com DRS pode estar relacionado à progressão da DAC. Os hormônios esteróides testosterona, progesterona e estradiol estão relacionados ao estresse oxidativo, e podem ter papel em ambas as doenças. A enzima glutationa S-tranferase utiliza a molécula antioxidante glutationa na detoxificação de compostos que podem ser formados neste processo. A enzima paraoxonase-1 hidrolisa peróxidos lipídicos, atuando sobre as lipoproteínas de baixa densidade oxidadas (ox-LDL). Ox-LDL são marcadores de peroxidação lipídica, e são importantes na formação da placa aterosclerótica. O vaso dilatador óxido nítrico (NO●) é considerado ateroprotetor e pode estar reduzido, agravando a DAC. Objetivos: Estudar o estresse oxidativo e as alterações fisiopatológicas decorrentes da associação entre DRS e DAC, e avaliar a participação dos hormônios esteroides neste processo. Material e Métodos: 56 pacientes com prévio diagnóstico para Doença Aterosclerótica Coronariana (DAC) e avaliação do Índice de Apneias-hipopneias (IAH) para diagnóstico de Distúrbio Respiratório do sono (DRS) foram divididos em dois grupos, 29 pacientes controles e 27 pacientes com DAC, definidos por apresentarem obstrução coronariana >30%. Foram quantificadas as concentrações séricas dos triglicerídeos, HDL, LDL, ferritina, tranferrina e ferro disponível, assim como dos níveis séricos dos hormônios testosterona, estradiol e progesterona, das enzimas paraoxonase-1 e glutationa S-transferase, e das ox-LDL. Foram quantificadas as concentrações de glutationa total, glutationa reduzida, glutationa oxidada e nitritos e nitratos (medida indireta de NO●) em eritrócitos. A concentração do marcador de dano oxidativo em DNA 8-oxo-7,8-dihidro-2’-desoxiguanosina foi obtida em leucócitos. Resultados: Pacientes com DAC possuem reduzida concentração de nitritos e nitratos. A concentração de 8-OHdG, a atividade da GsT, os níveis de glutationa total, glutationa reduzida e glutationa oxidada, assim com o estradiol e a progesterona, não apresentaram relação com DAC ou DRS. Além do IAH, a redução da testosterona e do ferro disponível estão relacionados a DAC. A redução da atividade da paraoxonase-1 e a maior concentração de ox-LDL são preditores de DAC. A testosterona está relacionada à concentração de ferritina, transferrina e ferro disponível nestes pacientes. A ferritina correlacionou-se positivamente ao dano oxidativo em proteínas e com o IAH, negativamente aos níveis de nitritos e nitratos, e é maior nos pacientes com DAC. Conclusão: Baixos níveis de testosterona e ferro disponível, assim com o aumento da ferritina podem estar relacionados à fisiopatologia da associação entre DRS e DAC. Paraoxonase-1 e ox-LDL são importantes preditores de DAC, mas parecem não estar diretamente relacionados ao IAH nestes pacientes. / Title: Oxidative stress and steroid hormones in the association between Sleep Disordered Breathing and Coronary Artery Disease Introduction: Epidemiological studies have shown a possible association between Coronary Artery Disease (CAD) and Sleep Disordered Breathing (SDB). Evidences suggest that oxidative stress generated by the intermittent hypoxia experienced by patients with sleep disorders may be related to progression of CAD. The steroid hormones testosterone, progesterone and estradiol are related to oxidative stress, and may have a role in both diseases. Glutathione S-transferase uses the antioxidant molecule glutathione in the detoxification of compounds that can be formed in this process. The enzyme paraoxonase-1 hydrolyzes lipid peroxides, acting on oxidized low-density lipoproteins (ox-LDL). Ox-LDL are lipid peroxidation markers, being important for the atherosclerotic plaque formation. The vasodilator nitric oxide (NO●) is considered atheroprotective and can be reduced, aggravating DAC. Objective: Evaluate the oxidative stress and the pathophysiological changes arising from the association between SDB and CAD, and the role of steroid hormones in this process. Material and Methods: 56 patients with prior Coronary Artery Disease (CAD) diagnosis and apnea-hypopnea index (AHI) evaluation for diagnosis of sleep-disordered breathing (SDB) were divided into two groups, 29 control patients and 27 patients with CAD, defined by present a coronary obstruction > 30%. The serum concentration of triglycerides, HDL, LDL, ferritin, transferrin and available iron was obtained, as well as the serum levels of the hormones testosterone, estradiol and progesterone, enzymes paraoxonase-1 and glutathione S-transferase, and ox-LDL. Were measured concentrations of total glutathione, reduced glutathione, glutathione disulfide and nitrites and nitrates (NO● indirect measure) in erythrocytes. The concentration of the 8-oxo-7,8-dihydro-2'-deoxyguanosine, oxidative DNA damage marker, was obtained from leukocytes. Results: CAD patients have reduced concentrations of nitrates and nitrites. The concentration of 8-OHdG, GST activity, levels of total glutathione, reduced glutathione and glutathione disulfide, and estradiol and progesterone, showed no relationship with CAD or SDB. In addition to AHI, the reduction of testosterone and iron available are related to CAD. The reduced activity of paraoxonase-1 and the highest concentration of ox-LDL are CAD predictors. Testosterone is related to the concentration of ferritin, transferrin and iron available in these patients. Ferritin was positively correlated to oxidative damage in protein and with the AHI, and negatively to the levels of nitrites and nitrates, and is higher in CAD patients. Conclusion: Low testosterone levels and iron available, as well as the increase ferritin may be related to the pathophysiology of the association between SDB and CAD. Paraoxonase-1 and ox-LDL are important CAD predictors, but do not seem to be directly related to AHI in these patients.

Base teórica: Na apneia obstrutiva do sono (AOS) ocorrem obstruções totais ou subtotais da faringe, levando a despertares e/ou hipoxemia. Atinge principalmente pessoas acima de 70 anos. Causa despertares que contribuem para sonolência e diminuição da qualidade de vida. Nos despertares, ocorrem mudanças no controle autonômico. Indivíduos com dor possuem uma estimulação simpática constante durante o sono e episódios frequentes de excitação e despertar. Pacientes com dor e apneia apresentam redução da modulação vagal. O presente estudo avalia a atividade do sistema nervoso autonômico por meio de parâmetros cardíacos, sonolência, dimensões de dor com gravidade da apneia obstrutiva do sono em idosos. Métodos: Estudo transversal com indivíduos de ambos os sexos, com idade entre 65 a 80 anos, fisicamente independentes, com e sem dor crônica. A amostra foi dividida em dois grupos de acordo com a gravidade da AOS determinada pelo índice de apneiahipopneia (IAH) obtido por polissonografia portátil (IAH <15 / hora e IAH> 15 / hora). Questionários validados foram empregados para avaliar a dor e sonolência. Para avaliar a modulação simpática, utilizou-se análise espectral, avaliada durante 10 minutos de descanso, seguidos por 10 minutos de estimulação simpática com Stroop Color test. Resultados: Cinquenta e oito indivíduos, com idades entre 71 ± 4 anos, 40% homens, foram incluídos. Não foram observadas diferenças significativas em qualquer escala de dor ou sonolência entre grupos de gravidade da AOS. Os indivíduos com IAH> 15 mostraram atenuada resposta simpática ao estresse em comparação a indivíduos com IAH <15, apenas na presença de presença de dor crônica. Indivíduos com queixa de dor, mas com IAH <15 tiveram uma resposta simpática normal. Conclusão: Idosos com apneia, moderada a grave possuem atenuada reatividade simpática ao estresse mental na presença de dor crônica. / Background: In obstructive sleep apnea (OSA) occurs total or subtotal obstruction of the pharynx, leading to arousals and / or hypoxemia. Mainly affects people over 70 years. Awakenings contributing to cause drowsiness and decreased quality of life. In awakenings, changes occur in the autonomic control. People with pain have a constant sympathetic stimulation during sleep and frequent episodes of excitement and awakening. Patients with pain and apnea have reduced vagal modulation. This study evaluates the activity of the autonomic nervous system, drowsiness, score dimensions with severity of obstructive sleep apnea in the elderly. Methods: This cross-sectional study included individuals of both sexes, aged 65 to 80 years, physically independent, with and without chronic pain. The sample was divided in two groups according to OSA severity determined by the apnea-hypopnea index (AHI) obtained by out-of-center polysomnography (AHI< 15/hour and AHI>15/hour). Validated questionnaires were employed to assess pain and sleepiness. To assess sympathetic modulation, heart rate spectral analysis was evaluated during 10 minutes of rest, followed by 10 minutes of sympathetic stimulation with the Stroop Color Test. Results: Fifty-eight subjects, aged 71±4 years, 40% men, were included. No significant differences were seen in any scale of pain or sleepiness between OSA severity groups. Individuals with AHI>15 showed attenuated sympathetic response to stress compared to individuals with AHI<15, only in the presence of presence of chronic pain. Individuals reporting pain but with AHI<15 had a normal sympathetic response. Conclusion: Elderly subjects with moderate to severe sleep apnea present attenuated sympathetic reactivity to mental stress in the presence of chronic pain.

Introdução: A utilidade de questionários para o diagnóstico de apneia obstrutiva do sono está bem estabelecida em adultos, mas permanece indefinida em idosos. Objetivo: Avaliar as propriedades preditivas dos questionários mais comumente empregados na população em geral em idosos fisicamente independentes. Desenho: Transversal. Local: Unidade de cuidados primários de saúde pública filiada a hospital universitário. Participantes: Roncadores fisicamente independentes com idade entre 65 a 80 anos cadastrados em um hospital universitário foram abordados por telefone e convidados a participar. Métodos: Os participantes foram submetidos à polissonografia portátil. Sensibilidade, especificidade, razão de verossimilhança positiva e negativa, área sob a curva ROC e psicometria clássica foram utilizados para avaliar a precisão e a medição de propriedades diagnósticas de três instrumentos validados para uso na população geral, sendo incerta sua utilização em idosos. Resultados: A amostra de 131 idosos fisicamente independentes, 50% homens, 58% aposentados, foram incluídos. Epworth>6 apresentou uma precisão de 61% para identificar IAH≥15. Epworth>10, ponto de corte usualmente empregado em adultos, apresentou pior desempenho diagnóstico. Sexo masculino e ser aposentado tiveram menor probabilidade de estarem associados com apneia obstrutiva do sono grave. Para prever IAH≥15, a área sob a curva ROC para Epworth>6 foi significativa, mas não para STOP-bang>2 e Atenas>5. Na regressão logística para prever IAH≥15, controlando para diversos fatores, apenas Epworth>6 e Atenas>5 permaneceram significativas no modelo. Conclusão: Em idosos independentes, uma escala de sonolência de Epworth com ponto de corte de 6 tem melhor desempenho diagnóstico do que questionários comumente empregados para prever um IAH≥15. / Background: The usefulness of questionnaires for diagnosis of sleep apnea is well established in adults, but remains undefined in the elderly population. Objective: To evaluate the predictive properties of the most commonly employed questionnaires in physically independent elderly people from the general population. Design: Cross-sectional. Setting: Public health primary care unit affiliated to university hospital. Participants: Physically independent snorers aged 65 to 80 years adscript to a university hospital were approached by telephone and invited to participate. Measurements: Participants underwent portable polysomnography. Sensitivity, specificity, positive and negative likelihood ratios, area under the ROC curve, and classical psychometrics were used to assess diagnostic accuracy and measurement properties of three validated instruments for use in the general population, making their usability in elderly populations uncertain. Results: A sample of 131 independently-living elderly people, 50% male, 58% retired, was included. For identifying AHI≥15, an Epworth>6 had an accuracy of 61%. Epworth>10, the usually employed cut-off point in adults, had poorer diagnostic performance. Male gender and retirement were protective of more severe OSA. For predicting AHI≥15, the area under the ROC curve for Epworth>6 was significant, but not for STOP-Bang>2 and Athens>5. In logistic regression to predict AHI≥15, after controlling for several confounders, Epworth>6, and Athens>5 were the only variables that remained significant in the model. Conclusion: In independent elderly, an Epworth sleepiness scale cut-point of 6 has better diagnostic performance than commonly employed questionnaires to predict an AHI≥15.

Author's first name and surname: Bc. Martin Dvořáček Title of the master thesis: Physiotherapy as a way to improve adherence to CPAP therapy of patients with obstructive sleep apnea syndrom Department: Department of physiotherapy Supervisor: Mgr. Petr Bitnar The year of presentation: 2018 Abstract: Obstructive sleep apnea is the most common type of sleeping disorder. It is characterized by an excessive daytime sleepiness, deficits of cognitive functions, serious cardiovascular issues and general decrease in the quality of life. The golden standard of the treatment is CPAP therapy. However the long-term disadvantage of this method is the low rate of patients adherence. The minimum requirements for CPAP machines usage are only met by approximately fifty percent of the patients. The presented thesis is divided into three main parts. Firstly, the positive effects of CPAP therapy such as reduction of excessive daytime sleepiness, improvement of cognitive functions and overall increase of life quality of the patients were reviewed. In the next part the relationship between the monitored factors and patients adherence to CPAP was investigated. Lastly, the desired increase of patients adherence to CPAP therapy was tested. Selected patients were divided into three different groups according to their therapeutical...

INTRODUÇÃO: Hipoxemia é frequente em pacientes com fibrose cística (FC), portanto testamos a hipótese que a gravidade da doença na fibrose cística, está correlacionada a maior risco de apneia obstrutiva do sono (AOS). MÉTODOS: 34 pacientes realizaram avaliação clínico-funcional, polissonografia tipo III, espirometria, e dosagem de interleucina1-β (IL-1β). RESULTADOS: A média do índice de apneia hipopneia (IAH) foi de 4,8±2,6, saturação de oxigênio em ar ambiente 95,9±1,9% e escala de sonolência de Epworth (ESE) 7,6±3,8. Dezenove eram eutróficos, seis apresentavam risco nutricional e nove apresentavam desnutrição. No modelo multivariado para prever IAH, permaneceram significativas: estado nutricional (β= -0,386; p=0,014), saturação de oxigênio na vigília (β= -0,453; p=0,005) e ESE (β=0,429; p=0,006). CONCLUSÃO: Os maiores determinantes de apneia do sono foram o estado nutricional, saturação na vigília e sonolência. O modelo explica 51% da variância do IAH representando chance de definir clinicamente o risco de apresentar apneia do sono. / BACKGROUND: Hypoxemia is a frequent finding in cystic fibrosis patients; therefore we tested the hypothesis that disease severity in cystic fibrosis (CF) is correlated with increased obstructive sleep apnea (OSA) risk. METHODS: Thirty-four patients underwent clinical and functional evaluation, type III polysomnography, spirometry, and measurement of interleukin 1-β (IL-1β). RESULTS: The mean values for apnea hypopnea index (AHI), room-air oxygen saturation, and the Epworth sleepiness scale (ESS) were 4.8±2.6, 95.9±1.9%, 7.6±3.8, respectively. Nineteen patients had normal weight, six had nutritional risk, and nine had malnutrition. In the multivariate model to predict AHI, the following variables remained significant: nutritional status (β= -0.386, p=0.014), oxygen saturation during wakefulness (β= -0.453, p=0.005), and ESS (β=0.429; p = 0.006). CONCLUSION: The major determinants of sleep apnea were: nutritional status, oxygen saturation during wakefulness, and sleepiness. The model explains 51% of variance in AHI, representing the chance to clinically define the risk for sleep apnea.