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

Abstract

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. 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. 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. 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. 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.