Pulmonary rehabilitation and sleep quality: a before and after controlled study of patients with chronic obstructive pulmonary disease

Abstract

Background:Poor sleep quality is common in chronic obstructive pulmonary disease (COPD). It is associated with poor quality of life. Pulmonary rehabilitation (PR) improves quality of life, exercise capacity, and anxiety and depression. Its effect on sleep quality is uncertain.Aim:To determine whether PR improves sleep quality in COPD.Methods:A prospective controlled ‘before and after’ study of sleep quality in COPD patients attending a community PR programme was conducted. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Lung function, disease-specific quality of life (COPD assessment test—CAT), exercise capacity (incremental shuttle walk test—ISWT), and anxiety and depression (Hospital Anxiety and Depression Scale—HADS) were measured. Change in sleep quality was compared with a COPD control group.Results:Twenty-eight participants completed PR. The control group comprised 24 patients. Prevalence of poor sleep quality (PSQI ⩾5) was 78%. There were no differences between observation and control groups in sleep quality, age or severity. Quality of life was strongly correlated with quality of sleep (r=0.64, P<0.001). PR improved the quality of life (CAT change 3.0; 95% CI, 0.7–5.3), exercise capacity (ISWT change (metres) 81.0; 15.3–146.6), anxiety (HADS score ⩾8: change 2.33; 0.45–4.22), and depression (HADS score ⩾8: change 2.90; 1.92–3.88). PR did not improve sleep quality (PSQI mean change 0.79; −0.35 to 1.93).Conclusions:PR did not improve sleep quality in COPD despite improving quality of life, exercise capacity, anxiety and depression. New strategies, independent of PR, are required to improve sleep quality in COPD.

Effect of care protocol on the knowledge, practice and clinical outcomes of patients with chronic obstructive pulmonary disease

“…So, the care protocol was effective in decreasing hypercapnia that consequently affected the quality of sleep. While, McDonnell, Hogg, McDonnell and White (2014) [28] stated that pulmonary rehabilitation (PR) did not improve sleep quality in COPD as indicated by the scores of Pittsburgh Sleep Quality Index (PSQI).…”

The effects a respiration rehabilitation program on IADL, satisfaction with leisure, and quality of sleep of patients with chronic obstructive pulmonary disease

“…It is executed in accordance with client conditions and administered using an interdisciplinary approach in order to enhance quality of life, reduce depression, increase participation in daily activities through respiration function recovery, increase respiration muscle strength, and mitigate shortness of breath 6 , 7 , 8 , 9 ) . Previous studies have shown that most respiration rehabilitation programs for patients with COPD improved the quality of life and strength of respiration muscles 6 , 7 , 8 ) , but few studies 15 , 19 ) have been conducted to determine the impact of the disease on sleep quality (which is one of the main symptoms associated with shortness of breath and/or coughing), instrumental activities of daily living, or satisfaction with leisure, which are important indices for rehabilitation. Thus, this study aimed to determine the effect of a respiration rehabilitation program on quality of sleeping, instrumental activities of daily living, and satisfaction of leisure among patients with COPD.…”

Sleep Quality in COPD Patients; Incidence and Predictors of Poor Quality

“…In a study of 59 patients with moderate to severe COPD, Lewis et al, [21] showed that Poor Sleep Quality (PSQI >5) in 61% of COPD patients regardless of their advanced age. Other two studies showed higher values (78% and 78.1%) [22,23] . However, the patients numbers in those studies was small (28 and 64 patients respectively).…”