Pulmonary Rehabilitation Improves Sleep Quality in Chronic Lung Disease

Abstract

Sleep-related disorders are common in patients with chronic obstructive pulmonary disease (COPD) and, possibily, other lung disorders. Exercise has been shown to improve sleep disturbances. In patients with COPD, pulmonary rehabilitation (PR) produces important health benefits with improvement in symptoms, exercise tolerance, and quality of life. However, the effect of PR on sleep quality remains unknown. The aim of this observational study was to evaluate sleep quality in patients with chronic lung disease and the role of PR as a non-pharmacologic treatment to improve sleep. Sixty-four patients with chronic lung disease enrolled in an 8-week comprehensive PR program, and completed the study (48% male; obstructive [72%], restrictive [20%], mixed [8%]; 44% on supplemental oxygen). Baseline spirometry [mean (SD)]: FEV1% pred = 48.9 (17.4), FVC% pred = 72.5 (18.1), and FEV1/FVC% = 53.1 (18.9). Exercise tolerance and questionnaires related to symptoms, health-related quality of life (HRQL), and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) were obtained before and after PR. 58% reported poor sleep quality (PSQI > 5) at baseline. Sleep quality improved by 19% (p = 0.017) after PR, along with significant improvements in dyspnea, exercise tolerance, self-efficacy, and HRQL. Sleep quality in patients with chronic lung disease was poor. In addition to expected improvements in symptoms, exercise tolerance, and HRQL after PR, the subgroup of patients with COPD had a significant improvement in sleep quality. These findings suggest that PR may be an effective, non-pharmacologic treatment option for sleep problems in patients with COPD.

Sleep-related disorders in chronic obstructive pulmonary disease

“…Of the 46 patients with obstructive lung disease, the average Pittsburgh Sleep Quality Index global index before pulmonary rehabilitation was 6.6. A score of >5 suggests significant sleep disturbance [19]. The cause of this poor sleep quality in COPD is not entirely clear.…”

On the cutting edge of obstructive sleep apnoea: where next?

“…People with COPD frequently complain of sleep disturbances of various kinds and thus a comprehensive management strategy of these patients must take into account sleep problems given the prevalence and therapeutic options for these complaints. 44 …”

Chronic Obstructive Pulmonary Disease and Sleep Quality

“…Soler et al (2013) showed that pulmonary rehabilitation produced significant improvements in life quality perceptions of patients in relation to dyspnoea, exercise tolerance, self-effectiveness and health while 19% of the patients had improved/advanced sleep quality. Soler et al (2013) suggested that pulmonary rehabilitation may be an effective, non-pharmacologic treatment option for sleep problems in patients with COPD [74].…”

“…In COPD patients, good sleep quality also contributes to better overall health of patients [73]. Soler et al (2013) showed that pulmonary rehabilitation is effective in improving the sleep quality of patients with COPD [74]. Increased awareness by medical professionals of the sleep problems of patients with COPD is important, since the sleep quality has an effect on patients' quality of life.…”