Journal of Sleep Medicine & Disorders Cite this article: Kaya AG, Gulbay BE, Erdogan GA, Hasanzade H, Ciledag A, et al. (2016) A Case Report: Daytime Sleepiness in an Adult Patient with Cystic Fibrosis. J Sleep Med Disord 3(6): 1063. Central *Corresponding author Asliha n G urun Ka ya , De p a rtme nt o f C he st Dise a se s, Anka ra Unive rsity Sc ho o l o f Me d ic ine , Anka ra , Turke y, Tel: 903125956510, Email: Submitte d: 28 July 2016 Accepted: 09 August 2016 Publishe d: 13 August 2016 ISSN: 2379-0822 Copyright © 2016 Kaya e t al. OPEN ACCESS Ke ywo rds • Cystic fbrosis • Da ytime sle e p ine ss • Sle e p q ua lity • Na rc o le psy Case Report A Case Report: Daytime Sleepiness in an Adult Patient with Cystic Fibrosis Aslihan Gurun Kaya*, Banu Eris Gulbay, Gokcen Arkan Erdogan, Hasan Hasanzade, Aydin Ciledag, Zeynep Pinar Onen, Ozlem Ozdemir Kumbasar, and Turan Acican Department of Chest Diseases, Ankara University School of Medicine, Turkey Abstract Cystic fbrosis (CF) is the most common, life-threatening genetic disorder in white individuals. Daytime sleepiness is defned as the inability to stay awake and alert during the major episodes of the day or poor sleep quality are more common in the patients with CF. A 21-year-old male patient with CF admitted to hospital with lower respiratory tract infection. During the hospital stay, hospital crew noticed an excessive daytime sleepiness (EDS), which leads serious performance decrements. Epworth sleepiness score of patient was 14. Pittsburgh Sleep Quality Index revealed poor sleep quality. Full-night polysomnography showed an apnea hypopnea index (AHI) of 0.8 events/hour. Average sleep latency of 0 minute and sleep onset REM periods (SOREMP) were found 3 out of 5 naps on multiple sleep latency test (MSLT). The patient was diagnosed as narcolepsy type 1. CF patients commonly encounter daytime sleepiness beside poor sleep quality. There was no previous study describing narcolepsy accompanied by CF. Causes of excessive daytime sleepiness and poor sleep quality should be investigated in patients with CF. ABBREVIATIONS AHI: Apnea Hypopnea Index; ESS: Epworth Sleepiness Score; PSOI: Pittsburgh Sleep Quality Index; MSLT: Multiple Sleep Latency Test; SOREMP: Sleep Onset REM Periods INTRODUCTION Cystic fibrosis (CF) is the most common, life-threatening genetic disorder in white individuals, occurs in nearly 1/2000 live births [1,2]. Lung diseases such as bronchiectasis, airflow obstruction are the main determinant of mortality and morbidity in these patients [1,3]. Also, daytime sleepiness is defined as the inability to stay awake and alert during the major episodes of the day or poor sleep quality are common in the patients with CF [2]. Severe lung diseases, chronic anxiety, pain, depression and vitamin deficiencies may play significant role in this condition [2,4]. We report a male patient who had diagnosed with CF, presented with daytime sleepiness. CASE PRESENTATION A 21-year-old male patient who had diagnosed as CF, admitted to our hospital with cough, sputum and fever. Antibacterial and bronchodilator therapy was initiated. During the treatment, the hospital crew has noticed an excessive daytime sleepiness (EDS), which leads serious performance decrements. The patient’s history was including interesting details such as failed examinations because of dropping a sleep during the test. The patient denied snoring, witnessed apnea, restless legs or depression. His medical therapy contained mucolytic agents, pancreatic enzyme supplements and nebulized bronchodilators; ıt is known that none of these agents affect sleep prominently. During the last two years, the patient had also hypnagogic hallucinations and neck weakness producing head drop after laughing. Epworth sleepiness score (ESS) of the patient was 14 (>10 are considered to indicate excessive daytime sleepiness [5]. When we evaluated subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI), he showed poor quality of sleep. (The patient score was 6 and a score above 5 indicates poor sleep quality [6]. Full-night in- laboratory polysomnography (PSG) was performed the results are given on Table (1) and Figure (1). PSG revealed an apnea hypopnea index (AHI) of 0.8 events/hour. His multiple sleep latency test (MSLT) showed an average sleep latency of 0 minute and sleep onset REM periods (SOREMP) were found 3 out of 5 naps. There was also a SOREMP on preceding nocturnal polysomnogram. Thus, total SOREMPs of patient were