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Lin L, Song Q, Duan J, Liu C, Cheng W, Zhou A, Peng Y, Zhou Z, Zeng Y, Chen Y, Cai S, Chen P. The impact of impaired sleep quality on symptom change and future exacerbation of chronic obstructive pulmonary disease. Respir Res 2023; 24:98. [PMID: 36998013 PMCID: PMC10064786 DOI: 10.1186/s12931-023-02405-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
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.
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Folmer RL, Smith CJ, Boudreau EA, Totten AM, Chilakamarri P, Atwood CW, Sarmiento KF. Sleep disorders among rural Veterans: Relative prevalence, comorbidities, and comparisons with urban Veterans. J Rural Health 2022. [DOI: 10.1111/jrh.12722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Robert L. Folmer
- National Center for Rehabilitative Auditory Research (NCRAR) VA Portland Healthcare System Portland Oregon USA
- Department of Otolaryngology Oregon Health & Science University Portland Oregon USA
| | - Connor J. Smith
- Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University Portland Oregon USA
| | - Eilis A. Boudreau
- Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University Portland Oregon USA
- Department of Neurology Oregon Health & Science University Portland Oregon USA
| | - Annette M. Totten
- Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University Portland Oregon USA
| | - Priyanka Chilakamarri
- San Francisco VA Health Care System San Francisco California USA
- Department of Neurology University of California San Francisco California USA
| | - Charles W. Atwood
- Pulmonary Section and Sleep Medicine VA Pittsburgh Healthcare System Pittsburgh Pennsylvania USA
- Division of Pulmonary Allergy Critical Care Medicine UPMC and University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Kathleen F. Sarmiento
- San Francisco VA Health Care System San Francisco California USA
- Department of Medicine University of California San Francisco California USA
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