Daytime Sleepiness and Quality of Sleep in Patients with COPD Compared to Control Group

Abstract

Objectives:Chronic obstructive pulmonary disease (COPD) is a widespread disease. It produces some night symptoms such as nighttime cough and dyspnea. Then subjective and objective changes in sleep pattern are expected. Present study was conducted to determine frequency of sleepiness and quality of sleep in patients with COPD.Materials & Methods:Present case-control study has been performed on 120 patients with diagnosis of COPD who had been referred to pulmonary disease clinic in a University teaching hospital. One hundred twenty age- and sex- matched healthy individuals were recruited in the study and served as control. Spirometry (PFT) was performed for all patients. Patients were categorized under 3 groups in relation to their PFT as follow: mild COPD (FEV1/FVC<70% and FEV1≥80%), moderate COPD (FEV1/FVC<70% and 50%≤FEV1<80%), and severe COPD (FEV1/FVC<70% and FEV1<50%). Pittsburgh Sleep Quality questionnaire (PSQI) and Epworth Sleepiness Scale (ESS) were used to estimate quality of sleep and daytime sleepiness in the patients and control group. The collected data were analyzed using version 16 SPSS software. Student’s T- test, Chi- square and multiple logistic regressions were used as appropriated.Results:120 patients with COPD (79 males and 41 females) and 120 normal individuals responded to the questionnaires. Mean scores of quality of sleep were 8.03±3.66 and 4.2±2.8 in COPD patients and control group respectively. 32.1% of the patients had good sleep quality (PSQI score less than 5) and 67.9% had poor sleep quality. Daytime sleepiness (ESS≥ 10) was present in 34.8% of the patients and 15% of control people. Multiple logistic regressions showed that the patients reported significantly worse sleep quality and more daytime sleepiness than control group [OR=2.9; 95% CI (1.6-3.7) & OR=3.5; 95% CI (2.5-4.3) respectively].Conclusion:Results of present study confirmed that COPD is associated with daytime sleepiness and poor quality of sleep, possibly attributable to nighttime respiratory difficulties and concomitant sleep apnea. Assessment of the patients for symptoms of sleep apnea, daytime sleepiness should be a part of regular follow up visits of patients with COPD.

Subjective sleep quality in sarcoidosis

“…However these groups of patients were small and age and gender distributions were not homogeneous. In the present study we observed a similar prevalence of poor sleep quality that has been reported previously for patients with chronic lung disease using the PSQI score as to 67.9% and 70.0% in COPD respectively [30,31].…”

The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis

“…Studies that examined differences in PSQI global score between healthy subjects and patients suffering from a variety of disorders known to be associated with poor sleep, showed significant differences between groups [9,22,45,49,51,56,60,68,71,79]. Studies that examined differences within groups of people (i.e., race, age, sex, different symptom clusters within the same population, etc.)…”

“…[22,46,51,56,69,79]. The clinical samples combined comprised 538 individuals, and the non-clinical samples e 745 individuals.…”

Predictors of Increased Daytime Sleepiness in Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

“…They found significantly more subjects suffering from excessive daytime sleepiness among COPD patients than among controls. Patients with moderate COPD seemed to be the most affected [16]. …”