Sleep patterns in table chronic obstructive pulmonary disease patients at a tertiary care center: a hospital-based observational study

Abstract

Introduction: Sleep has significant adverse consequences for breathing and gas exchange in patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess sleep patterns in patients with stable COPD. Patients and methods: Patients with stable COPD were recruited from a tertiary care hospital. Data collected included demographic profile, clinical characteristics of COPD, neck circumference, Epworth sleepiness scale (ESS) score, and sleep variables using polysomnography. Results: Of recruited 40 patients, 12 fulfilled the inclusion criteria. The mean age of the patients was 57.42 ± 10.98 years and 11 were males. Eight patients (66.7%) had moderately severe COPD, three mild, and one severe COPD. Eleven patients had a normal ESS score. None had excessive day-time sleepiness. High numbers of arousal and sleep-stage change characterized major sleep fragmentation were reported in these individuals. Apnea–hypopnea index was normal, that is, 3.2 ± 1.9 (mean ± standard deviation [SD]). The total sleep time with hemoglobin saturation under 90% (T90) was 48.17 ± 5.79 minutes (mean ± SD). Hemoglobin saturation fell more in rapid eye movement (REM) sleep (87.1% ± 5.5%) than non-REM sleep (88.6% ± 4.8%). Sleep-onset latencies were 19.21 ± 4.68 (mean ± SD) minutes and REM latency was 126 ± 9.39 (mean ± SD) minutes. The mean %wake stage, mean% Stage 1 sleep, and mean% Stage 2 sleep were prolonged in most patients, whereas REM sleep was decreased in all patients. Conclusion: Sleep is characterized by major sleep fragmentation even in patients with stable COPD. Extent and duration of desaturation during sleep are significant. Wake stage, Stage 1, and Stage 2 sleep are prolonged in most patients. REM sleep is decreased in all patients.