Sleep Quality and Nocturnal Symptoms in a Community-Based COPD Cohort

Abstract

Small studies have suggested that patients with chronic obstructive pulmonary disease (COPD) have poor sleep quality. Our aim was to examine the prevalence of subjective sleep-related complaints and predictors of poor sleep quality in a large community-based COPD cohort. We analyzed cross-sectional data on sleep questionnaire responses from the Canadian Cohort of Obstructive Lung Disease (CanCOLD) study, a population-based, prospective longitudinal cohort study across Canada. The cohort comprises a COPD group and two matched non-COPD (neversmokers and ever-smokers) groups. Sleep-related symptoms were assessed using questionnaires including Pittsburgh Sleep Quality Index (PSQI). A total score of PSQI > 5 is indicative of poor sleep quality. Health-related quality of life measures and the presence of mood disturbance were assessed using Short Form-36 TM Health Survey (SF-36) multi-item questionnaires and Hospital Anxiety and Depression Scale (HADS), respectively. Predictors of poor sleep quality were analyzed using multivariable logistic regression analysis. Of the 1123 subjects, 263 were healthy controls, 323 at-risk controls, and 537 had COPD (297 had mild, 240 with moderate to severe disease). The mean PSQI score was not significantly different between groups. COPD patients with poor sleep quality had lower diffusion capacity, higher HADS anxiety and depression scores and lower SF-36 mental and physical component summary scores than COPD patients classified as good sleepers. The presence of restless legs and obstructive sleep apnea symptoms, waist circumference, predicted diffusion capacity and HADS anxiety and depression scores were identified as independent predictors of poor sleep quality.

The Relationship Between Sleep Quality and Quality of Life Among Patients With Asthma

“…Numerous studies have shown that QoL indices have significant determining effects on the classification, diagnosis, and treatment of asthmatic patients [ 6 , 15 ]. Although there are various tools for the assessment of QoL [ 8 , 10 , 15 , 16 ], the 36-Item Short-Form Health Survey QoL questionnaire (SF-36) is one of the most commonly used tools in this field [ 15 , 17 - 19 ]. It is well-established and appropriate for evaluating the effects of chronic diseases and their treatments on QoL [ 7 , 10 , 20 , 21 ] and hence could have some role in measuring the burden of the disease [ 3 , 9 ].…”

A Systematic Literature Review of the Humanistic Burden of COPD

“…18 Furthermore, Shah et al reported that sleep disturbances can lead to increased exacerbation frequency and healthcare resource utilization. 59 In summary, the data found during this review indicated that comorbidities were associated with a reduction in HRQoL. In particular, mental health-related comorbidities were increasingly cited as airflow limitation severity increased, further decreasing HRQoL in patients with COPD.…”

“… 18 Furthermore, Shah et al reported that sleep disturbances can lead to increased exacerbation frequency and healthcare resource utilization. 59 …”

Sleep quality in stable chronic obstructive pulmonary disease patients in Zagazig University Hospitals, Egypt

“…Abd El-Fattah et al [35] confirmed that there is strong association between poor sleep quality and physical limitation, COPD exacerbation, anxiety, depression, and poor health-related quality of life after using a group of subjective questionnaires for its assessment, and lastly, Shah et al [38] noticed that presence of restless legs and obstructive sleep apnea symptoms, waist circumference, predicted diffusion capacity, and HADS anxiety and depression scores were identified as independent predictors of poor sleep quality.…”