The association between characteristics of sleep and physical activity in daily life (PADL) was not yet investigated in depth in subjects with chronic obstructive pulmonary disease (COPD). This study evaluated if time spent/day in physical activity (PA) and sedentary behaviour are associated with sleep quantity and quality in this population.Sleep and PADL were objectively assessed by an activity monitor for 7 days and analysed on a minute-by-minute basis. Subjects also underwent spirometry and 6-min walking test (6 MWT).Fifty-five subjects with moderate-to-severe COPD (28 male, 67±8 years) were studied. Subjects with total time in bed/night (TIB) ≥9 h had higher wake after sleep onset than TIB 7–9 h and TIB≤7 h (195 [147–218] versus 117 [75–167] and 106 [84–156] min) and more fragmented sleep than TIB≤7 h (8.2 [6.7–14.3] versus 6.3 [5.6–6.9] sleeping bouts)(p<0.05 for all). Subjects with TIB≥9 h also spent more time/day in sedentary behaviour and less time/day in PA of light and moderate-to-vigorous intensity than those with TIB 7–9 h and ≤7 h. In multiple linear regression, TIB≥9 h was the only significant predictor of physical inactivity (β=−3.3 [−5.1, −1,6], p≤0.0001), accounting for 20% of its variation. Sleep fragmentation was frequent and more pronounced in physically inactive than active patients (7.5 [6.3–9.6] versus 6.4 [5.5–7.3] sleeping bouts; p=0.027).In summary, subjects with COPD with time in bed ≥9 h·night−1 have more fragmented sleep, are more sedentary and less physically active than those with <9 h·night−1, independently of the awake time. Sleep quality is frequently poor and even worse in patients classified as physically inactive.

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Objective: To evaluate sleep-onset time variability, as well as sleep characteristics on weekday and weekend nights, in individuals with moderate-to-severe COPD. Methods: Sleep was objectively assessed by an activity/sleep monitor for seven consecutive nights in individuals with COPD. For analysis, individuals were divided into two groups according to sleep-onset time variability results, characterized by intrasubject standard deviation of sleep-onset time (SOTV) = 60 min or < 60 min. Results: The sample comprised 55 individuals (28 males; mean age = 66 ± 8 years; and median FEV1 % of predicted = 55 [38-62]). When compared with the SOTV<60min group (n = 24), the SOTV=60min group (n = 31) presented shorter total sleep time (5.1 ± 1.3 h vs. 6.0 ± 1.3 h; p = 0.006), lower sleep efficiency (73 ± 12% vs. 65 ± 13%; p = 0.030), longer wake time after sleep onset (155 ± 66 min vs. 115 ± 52 min; p = 0.023), longer duration of wake bouts (19 [16-28] min vs. 16 [13-22] min; p = 0.025), and higher number of steps at night (143 [104-213] vs. 80 [59-135]; p = 0.002). In general, sleep characteristics were poor regardless of the day of the week, the only significant difference being that the participants woke up about 30 min later on weekends than on weekdays (p = 0.013). Conclusions: Sleep-onset time varied over 1 h in a standard week in the majority of individuals with COPD in this sample, and a more irregular sleep onset indicated poor sleep quality both on weekdays and weekends. Sleep hygiene guidance could benefit these individuals if it is integrated with their health care.

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Este é um artigo publicado em acesso aberto (Open Access) e distribuído sob a licença Creative Commons Attribution NonComercial ShareAlike License, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que sem fins comerciais e que o trabalho original seja corretamente citado e de forma que não indique endosso ao trabalho feito. Adicionalmente, qualquer trabalho derivado deverá ser publicado sob a mesma licença. ResumoIntrodução: Não está claro se a pior qualidade do sono apresentada por indivíduos com Doença Pulmonar Obstrutiva Crônica (DPOC) correlaciona-se aos sintomas comumente desencadeados pela doença. Objetivos: Investigar se existe correlação entre a qualidade do sono com estado funcional, estado de saúde, dispneia, ansiedade, depressão e qualidade de vida em indivíduos com DPOC. Métodos: Indivíduos com DPOC foram avaliados transversalmente quanto à qualidade do sono pelo Pittsburgh Sleep Quality Index (PSQI) e esta foi correlacionada com os instrumentos: Medical Research Council scale (MRC), Hospital Anxiety and Depression scale (HADS), London Chest Activity of Daily Living (LCADL), Chronic Respiratory Questionnaire (CRQ) e COPD Assessment Test (CAT). Os escores gerais e por domínios foram utilizados para as análises. As correlações foram avaliadas pelo coeficiente de correlação de Spearman, e a significância estatística de P<0,05. Resultados: Foram incluídos dezoito indivíduos com DPOC ( 67% homens; 64[60-71] anos; VEF 1 48[41-58]%predito), em sua maioria com má qualidade do sono (6[4-9]pontos). A qualidade do sono e a disfunção diurna (PSQI) correlacionaram-se moderadamente com os domínios fadiga e emocional do CRQ (-0,68 ≤ r ≤ 0,61) e fortemente aos distúrbios do sono, assim como com o sono avaliado pelo CAT (r=-0,80; -0,79 e 0,73, respectivamente). Além disso, a latência do sono correlacionou-se com o domínio auto-controle do CRQ (r=-0,70) e com a dispneia do CAT (r=0,47). Conclusão: A qualidade do sono dos indivíduos com DPOC correlaciona-se moderadamente a fortemente com a fadiga, questões emocionais, dispneia, qualidade de vida e funcionalidade dessa população.

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