Background and objectives: Obesity and anxiety and/or depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD). For doctors treating COPD, cough has a certain importance as a symptom. The purpose of this study was to figure out how obesity and anxiety/depression may influence the subjective assessment of cough. Materials and Methods: 110 patients with COPD participated in the study. The patients were divided into two groups, one including obese patients, and the other including patients with normal body weight. All patients filled out the hospital anxiety and depression scale (HADS) questionnaire, evaluated the severity of their cough by using visual analogue scale (VAS) on the 1st and 10th day of treatment, and underwent a 12 h cough monitoring with a special cough monitoring device both on the 1st and the 10th day of treatment. Results: The severity of anxiety according to the HADS in patients with COPD and normal body weight was significantly higher than in patients with COPD and obesity, corresponding to 9.25 ± 1.37 and 8.20 ± 1.18 points, respectively (p = 0.0063). The patients with normal body weight and obesity, but without anxiety and depression, subjectively noted an improvement in their well-being on the 10th day of treatment (p = 0.0022, p = 0.0021, respectively). In subgroups with normal body weight and obesity with anxiety and/or depression, the mean values for VAS on day 10 did not change significantly (p = 0.1917, p = 0.1921, respectively). Also, patients from the subgroup with normal body weight and anxiety/depression had a significantly higher assessment of their cough on day 10 than obese patients with anxiety/depression (p = 0.0411). The VAS values correlated positively with the actual amount of cough (r = 0.42, p = 0.0122 and r = 0.44, p = 0.0054, respectively) in patients without anxiety and/or depression, while in patients with anxiety and/or depression, there was an inverse correlation between VAS values and cough (r = −0.38, p = 0.0034 and r = −0.40, p = 0.0231). Conclusions: It is important to diagnose and treat anxiety and depression in patients with COPD for a better prognosis and higher efficacy of medical treatments. While treating such patients, it is preferable to use a cough monitoring device for objective assessments, since the patients may exaggerate or underestimate their symptoms.

This literature review gives the results of clinical trials studying the association of the level of endogenous melatonin and blood pressure (BP), the effects of exogenous melatonin on BP (particularly at night) in relation to the used rapid- or controlled-release formulation of melatonin.

Aim. To assess the influence of training of respiratory musculature on the expressiveness of symptoms, tolerance to physical loads, spirometric parameters and quality of life of patients with chronic obstructive pulmonary disease (COPD) and obesity. Materials and Methods. The study included 52 patients with COPD (clinical group D) and obesity, of them 42 men and 10 women with the mean age 65.4±6.8 years and body mass index 33.6±2.9 kg/m2. The patients were divided to 2 groups: the main group with training of respiratory musculature (TRM) within 12 months using a respiratory exerciser, and the control group with simulation of TRM using the same exerciser, but with minimal load. Results. In 12 months the patients of the main group showed a reliable reduction of dyspnea on mMRC scale (Modified Medical Research Council), improvement of health related quality of life on St. George’s Respiratory Questionnaire (SGRQ), increase in forced expiration volume in 1 second and in forced vital capacity of lungs, increase in the covered distance in 6-minute walk test, reduction of the average duration of hospitalization for exacerbation of COPD. Conclusion. Taking into account the obtained data, TRM can be considered as an effective component of the lung rehabilitation program in patients with COPD.

Background: Chronic obstructive pulmonary disease (COPD) may frequently be complicated by sleep disorders, which worse quality of life and lead to other adverse consequences. The objective of the study was to analyze clinical course of the disease and quality of life in elderly patients with both COPD and sleep disorders. Methods and Results:The study included 50 patients with moderate and severe COPD in age from 60 to 75 years (mean age, 66.12±0.76 years). Patients were divided into 2 groups randomly. For patients in Group 1, 3 mg of melatonin was prescribed orally 30-40 minutes before bedtime for 14 days on the background of standard COPD therapy. Patients of Group 2 received only standard COPD therapy. After 12 months of follow-up, the number of exacerbations and hospitalizations for COPD significantly decreased in Group 1: from 3.74±0.19 to 1.91±0.20 times a year (P=0.0000) and from 2.08±0.18 to 1.35±0.18 (P=0.0046). In Group 2, the dynamics of these parameters was not statistically significant. In addition, along with the improvement of sleep quality in COPD patients during treatment with melatonin, both state and trait anxiety scores and depression level improved. In Group 1, SF-36 scores (PF, RP, BP, and GH) have also significantly improved.Conclusion: Correction of sleep disorders by melatonin in elderly patients with COPD improved the effectiveness of COPD treatment, and reduced the frequency and duration of exacerbations and the number of outpatient visits and hospitalizations.