The overlooked factor: Sleep quality in assessing malnutrition risk and nutritional status in adolescents with cystic fibrosis

Aim: This study aimed to assess the relationship between sleep quality, malnutrition risk, and nutritional status in adolescents with cystic fibrosis(CF). Material and method: This cross-sectional study was conducted with 55 adolescents (aged 10-18 years) diagnosed with CF. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and malnutrition risk was evaluated based on disease-specific criteria. Nutritional status was assessed using body mass index (BMI), BMI percentiles, dietary energy intake, and food group consumption. Multiple linear regression analyses were used to determine the relationship between sleep quality, malnutrition risk, and nutritional status. Results: Among the participants, 50.9 % had poor sleep quality, and 29.1 % were classified as high-risk for malnutrition. Poor sleep quality was significantly associated with increased malnutrition risk (p < 0.05), independent of dietary energy intake and BMI percentiles. Lower BMI percentile was strongly associated with higher malnutrition risk (p < 0.001), identifying BMI as a critical predictor. Specifically, 27.3 % of participants had a BMI <10th percentile, which contributed to their classification as high-risk for malnutrition. However, dietary energy intake did not significantly predict malnutrition risk despite its relevance in dietary management. Conclusion: This study emphasizes the crucial role of sleep quality in assessing malnutrition risk among adolescents with CF. Poor sleep quality was associated with higher malnutrition risk, suggesting that sleep disturbances may contribute to nutritional challenges. Sleep quality should be considered a key factor in assessing malnutrition risk among adolescents with CF and integrated into clinical practice to develop comprehensive management strategies addressing sleep disturbances and nutritional challenges, improving health outcomes.