Therapy for insomnia with chronic obstructive pulmonary disease: a randomized trial of components

Kapella, Mary C.; Steffen, Alana; Prasad, Bharati; Laghi, Franco; Vispute, Sachin; Kemner, Gretchen; Teixeira, Celso; Peters, Tara; Jun, Jeehye; Law, Julie; Carley, David W.

doi:10.5664/jcsm.10210

Cited by 5 publications

(7 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cognitive-behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia and is associated with reduced healthcare utilization and costs [ 59 , 60 ]. A recent clinical trial of CBT-I in patients with COPD reported decreases in insomnia and improvements in fatigue and dyspnea [ 61 ]. Hypnotics, including benzodiazepine receptor agonists and sedating antidepressants, should be used with caution in patients with severe COPD and used short-term or intermittently in more stable patients as long-term use may be associated with adverse respiratory outcomes [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs

2023

View full text Add to dashboard Cite

Insomnia has been linked to adverse chronic obstructive pulmonary disease (COPD) outcomes including exacerbations, yet its impact on COPD-related healthcare utilization and costs is unknown. In this study, we investigated the associations between insomnia and healthcare utilization and costs in patients with COPD. A retrospective cohort of veterans with COPD were identified from national Veterans Affairs administration data for fiscal years 2012–2017. Insomnia was operationalized as having an insomnia diagnosis based on International Classification of Disease codes or having a prescription of > 30 doses of a sedative-hypnotic medication in a given fiscal year. The index date for insomnia was the first date when dual criteria for COPD and insomnia was met. The index date for those without insomnia was set as the COPD index date. Our primary outcomes were 1-year healthcare utilization and costs related to outpatient visits and hospitalizations after index date. COPD-related healthcare utilization variables included number of prescription fills of corticosteroids and/or antibiotics and outpatient visits and hospitalizations with a primary diagnosis of COPD. Out of 1,011,646 patients (96% men, mean age 68.4 years) diagnosed with COPD, 407,363 (38.8%) had insomnia. After adjustment for confounders, insomnia was associated with higher rates of outpatient visits, hospitalizations, and fills for corticosteroids and/or antibiotics, longer hospital length of stay, and $10,344 higher hospitalization costs in the 12 months after index date. These findings highlight the importance of insomnia as a potentially modifiable target for reducing the burden of COPD on patients and healthcare systems.

show abstract

Section: Discussionmentioning

confidence: 99%

Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs

2023

View full text Add to dashboard Cite

show abstract

“…This cross-sectional study was carried out using secondary analysis of data from a parent study that aimed to determine the efficacy of behavioral therapy for insomnia and fatigue in people with COPD. 1 A total of 102 subjects having COPD and co-existing insomnia were included in the study. The study was approved by the Institutional Review Board of the University of Illinois Chicago (2013-0626).…”

Section: Design and Participantsmentioning

confidence: 99%

“…The inclusion and exclusion criteria for this study were the same as those identified in the parent study. 1 To sum up, people with mild to very severe COPD were included if they had self-reported insomnia (i.e., an Insomnia Severity Index [ISI] score of at least 8), were aged ≥45 years and had no other major health problems, and were clinically stable without major COPD exacerbation. However, individuals were excluded if they showed evidence of restrictive lung disease or asthma, sleep disorders (e.g., sleep apnea), acute respiratory infection, debilitating disease (e.g., cancer, congestive heart failure, liver failure), musculoskeletal or degenerative nerve disease, major depression (i.e., a Hospital Anxiety and Depression Scale depression score >11) or psychiatric disease, use of hypnotics, or current participation in pulmonary rehabilitation.…”

Section: Design and Participantsmentioning

confidence: 99%

“…The overall reliability of the CRQ-D (Cronbach's alpha = 0.86) and CRQ-F (Cronbach's alpha = 0.85) has been demonstrated for the COPD population. 1 Anxiety and Depression. Anxiety and depression were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive testing (CAT) versions for anxiety and depression.…”

Section: Symptom Variablesmentioning

confidence: 99%

“…People with chronic obstructive pulmonary disease (COPD) and comorbid insomnia experience multiple concurrent symptoms, including disease-related symptoms such as dyspnea, fatigue, anxiety, and depression along with insomnia. 1 Such symptoms impose a substantial burden on people with COPD and insomnia in terms of reduced quality of life, 2 increased risk of COPD exacerbation, more severe disease prognosis, and higher morbidity and mortality. 2,3 Despite this high symptom burden in people with COPD experiencing insomnia, most studies in this population have been limited to the relationship between two symptom variables, and no studies have identified the characteristics of symptom clusters.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Symptom Cluster Profiles in Adults with Chronic Obstructive Pulmonary Disease and Insomnia

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background: People with chronic obstructive pulmonary disease (COPD) and insomnia may experience multiple symptoms that can affect physical function, but little research has focused on symptom clusters in this population. Objectives: This study aimed to identify subgroups of people with COPD and insomnia based on a pre-specified symptom cluster and determine whether physical function differed in the subgroups. Methods: This secondary data analysis included 102 people with insomnia and COPD. Latent profile analysis classified subgroups of individuals sharing similar patterns of five symptoms: insomnia, dyspnea, fatigue, anxiety, and depression. Multinomial logistic regression and multiple regression determined factors associated with the subgroups and whether physical function differed among them. Results: Three groups of participants were identified based on the severity of all five symptoms: low (Class 1), intermediate (Class 2), and high (Class 3). Compared to Class 1, Class 3 showed lower self-efficacy for sleep and for COPD management and more dysfunctional beliefs and attitudes about sleep. Class 3 showed more dysfunctional beliefs and attitudes about sleep than Class 2. Class 1 showed significantly better physical function than Classes 2 and 3. Conclusions: Self-efficacy for sleep and for COPD management and dysfunctional beliefs and attitudes about sleep were associated with class membership. As physical function differed among subgroups, interventions to improve self-efficacy for sleep and for COPD management and minimize dysfunctional beliefs and attitudes about sleep may reduce symptom cluster severity, in turn enhancing physical function.

show abstract

Behavioral interventions and symptom cluster change in adults with chronic obstructive pulmonary disease and insomnia

Jun,

Park,

Fritschi

et al. 2024

Heart & Lung

View full text Add to dashboard Cite

Therapy for insomnia with chronic obstructive pulmonary disease: a randomized trial of components

Cited by 5 publications

References 46 publications

Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs

Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs

Symptom Cluster Profiles in Adults with Chronic Obstructive Pulmonary Disease and Insomnia

Behavioral interventions and symptom cluster change in adults with chronic obstructive pulmonary disease and insomnia

Contact Info

Product

Resources

About