{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T19:10:30Z","timestamp":1776712230540,"version":"3.51.2"},"reference-count":60,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep\u2010disordered breathing (SDB) is an increasingly recognized yet underappreciated contributor to morbidity in people with cystic fibrosis (pwCF). While SDB, including nocturnal hypoxemia, hypoventilation, and obstructive sleep apnea (OSA), is well documented in high\u2010income countries (HICs), evidence from low\u2010 and middle\u2010income countries (LMICs) remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This narrative review synthesizes available evidence on the prevalence, clinical characteristics, diagnostic practices, and management approaches of SDB in pwCF living in LMICs, with a particular focus on studies using polysomnography (PSG) and overnight oximetry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings from upper\u2010middle\u2010income countries such as Brazil and Turkey indicate substantial rates of OSA and nocturnal desaturation, even among clinically stable individuals. Studies using PSG or overnight oximetry have linked these disturbances to lower lung function, poor nutritional status, and increased healthcare utilization. Despite the clinical relevance of these findings, access to diagnostic tools such as PSG and treatment modalities such as non\u2010invasive ventilation remain severely limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SDB represents a clinically relevant but underdiagnosed comorbidity in pwCF residing in LMICs. There is an urgent need for increased clinical awareness, implementation of low\u2010cost screening tools, and development of resource\u2010adapted diagnostic and management strategies to improve comprehensive CF care in underserved regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71515","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T12:50:12Z","timestamp":1770900612000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sleep\u2010Disordered Breathing in Cystic Fibrosis in Low\u2010 and Middle\u2010Income Countries"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2146-3966","authenticated-orcid":false,"given":"Merve Sel\u00e7uk","family":"Balc\u0131","sequence":"first","affiliation":[{"name":"Division of Pediatric Pulmonology Hatay Training and Research Hospital  Hatay Turkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasemin","family":"G\u00f6kdemir","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8829-3431","authenticated-orcid":false,"given":"Ela Erdem","family":"Eralp","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology Marmara University School of Medicine Istanbul Turkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Refika","family":"Ersu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Respirology Children's Hospital of Eastern Ontario Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.10"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32542-3"},{"issue":"1","key":"e_1_2_13_4_1","first-page":"S23","article-title":"Sleep\u2010Disordered Breathing in Cystic Fibrosis","volume":"56","author":"Jagpal S. K.","year":"2021","journal-title":"Pediatric Pulmonology"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2014.06.005"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2018.07.002"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2023.12.005"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2018.03.001"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2020.07.004"},{"key":"e_1_2_13_10_1","unstructured":"The World Bank. World Bank Country and Lending Groups [Internet]. Washington (DC): The World Bank Group; 2025 accessed August 2 2025 https:\/\/datahelpdesk.worldbank.org\/knowledgebase\/articles\/906519."},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.917221"},{"key":"e_1_2_13_12_1","unstructured":"Cystic Fibrosis Foundation. 2024 Patient Registry Highlights. Bethesda MD: Cystic Fibrosis Foundation; 2025."},{"key":"e_1_2_13_13_1","unstructured":"ECFSPR Annual Report 2023. Zolin A Adamoli A Bakkeheim E 2025."},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2109080"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922814527501"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-007-0123-0"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.142141"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-022-02243-0"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2020.101279"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneumo.2018.09.012"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2019.08.015"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2025.01.018"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15553"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24780"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03665"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1806-37132013000600005"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-011-0599-5"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-079X.2009.00726.x"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2009.09.037"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21122"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20643"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(01)00157-5"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.5.1593"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2021.05.005"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.84.4.388"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1980.02130200004002"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.84.1.50"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.071795"},{"issue":"4","key":"e_1_2_13_39_1","first-page":"202","article-title":"Respiratory Sleep Disturbance in Children and Adolescents With Cystic Fibrosis","volume":"22","author":"Silva A. M.","year":"2016","journal-title":"Revista portuguesa de pneumologia"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-300440"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.97.10091999"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2004.07.002"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2012.1177"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200709-155MG"},{"issue":"8","key":"e_1_2_13_45_1","first-page":"741","article-title":"Sleep Hypoxemia in Young Adults With Cystic Fibrosis","volume":"134","author":"Stokes D. C.","year":"1980","journal-title":"American journal of diseases of children (1960)"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1808-86942009000600006"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2000.00241.x"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25811"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(22)00262-4"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0954-6111(98)90302-X"},{"issue":"9","key":"e_1_2_13_51_1","first-page":"527","article-title":"Long\u2010Term Non\u2010Invasive Positive Pressure Ventilation Among Cystic Fibrosis Patients Awaiting Lung Transplantation","volume":"6","author":"Efrati O.","year":"2004","journal-title":"Israel Medical Association journal: IMAJ"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.27061"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1159\/000524773"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2025.02.010"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26954"},{"key":"e_1_2_13_56_1","unstructured":"M. M.Troester S. F.Quan R. B.Berry et al. for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules Terminology and Technical Specifications. Version 3. Darien IL: American Academy of Sleep Medicine; 2023."},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-69479-0"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15091088"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30198-5"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26802"},{"key":"e_1_2_13_61_1","doi-asserted-by":"publisher","DOI":"10.1159\/000543343"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71515","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71515","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:18:47Z","timestamp":1773015527000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":60,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/ppul.71515"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71515","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-08-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71515"}}