The impact of impaired sleep quality on symptom change and future exacerbation of chronic obstructive pulmonary disease

Abstract

Purpose Study the impact of impaired sleep quality on symptom change and future exacerbation of chronic obstructive pulmonary disease (COPD) patients. Methods This was a prospective study. Patients with COPD were recruited into the study and followed up for one year. Pittsburgh sleep quality index (PSQI) was collected at baseline. Symptom change was assessed with Minimum clinically important difference (MCID) in COPD Assessment Test (CAT) at 6-month visit, which is an indicator to assess symptom improvement. Exacerbation was recorded during the one-year visit. PSQI score > 5 was defined as poor sleep quality, whereas PSQI score ≤ 5 was defined as good sleep quality. MCID was defined as attaining a CAT decrease ≥ 2. Results A total of 461 patients were enrolled for final analysis. Two hundred twenty-eight (49.4%) patients had poor sleep quality. Overall, 224 (48.6%) patients attained MCID at 6-month visit and the incidence of exacerbation during the one-year visit was 39.3%. Fewer patients with impaired sleep quality achieved MCID than patients with good sleep quality. Good sleepers were significantly more likely to attain MCID (OR: 3.112, p < 0.001) than poor sleepers. Fewer poor sleepers in GOLD A and D groups attained MCID with ICS/LABA, and fewer poor sleepers in the GOLD D group attained MCID with ICS/LABA/LAMA than good sleepers. Poor sleep quality was a greater risk factor of future exacerbation in Cox regression analysis. The ROC curves showed that PSQI score had a predictive capacity for future exacerbation. More patients with poor sleep quality experienced future exacerbation in GOLD B and D group with treatment of ICS/LABA/LAMA compared to good sleepers. Conclusions COPD patients with impaired sleep quality were less likely to achieve symptom improvement and were at increased risk of future exacerbation compared to patients with good sleep quality. Besides, sleep disturbance may affect the symptom improvement and future exacerbation of patients with different inhaled medication or in different GOLD groups.

Parents’ Perceptions of Changes in Sleep Duration, Physical Activity, and Sedentary Behavior in Arab Israeli Children during the COVID-19 Outbreak

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The clinical characteristics and treatment response of patients with chronic obstructive pulmonary disease with low body mass index

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Neural alterations of Omicron infection comorbid with insomnia in Chinese: Insight from surface-based morphometry and bibliometric analysis

“…Backward DST test (BDST), central nervous system (CNS), coronavirus disease 2019 (COVID- 19), digital symbol substitution test (DSST), digit span test (DST), forward DST (FDST), grey matter volume (GMV), grey matter (GM), healthy controls (HCs), logical memory test (LMT)-A/B, magnetic resonance imaging (MRI), Omicron infection with insomnia group (Omicron_insomnia group), Omicron infection without insomnia group (Omicron_non_insomnia group), Pittsburgh sleep quality index (PSQI), white matter (WM), word uency test (WFT), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), surface-based morphometry (SBM), superior temporal gyrus (STG), self-rating depression scale (SDS), self-rating anxiety scale (SAS).…”

“…(i) The sleep quality is assessed via Pittsburgh sleep quality index (PSQI), which consists of 18 items covering 7 components. The overall score ranges from 0 to 21 (cutoff value set at 5), with scores (> 5) indicating insomnia (Lin et al 2023). (ii, iii) The self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were reliably used to assess emotional status over the past two weeks.…”

“…To enhance data accuracy, synonyms and related terms were incorporated in the keyword search. The following search string was used: ((TS=(insomnia)) AND (TS=(COVID- 19) or TS=(COVID19) or TS=(corona virus disease 2019) or TS=(coronavirus disease 2019) or TS=(corona virus disease- 19) or TS=(coronavirus disease- 19) or TS= (SARS-CoV-2) or TS=( severe acute respiratory syndrome coronavirus 2))). We also restricted the retrieved articles to those published before January 1, 2024 and limited them to article and review with English language.…”