Total Sleep Time in the Taiwan Obstructive Lung Disease Cohort.

Li-Pang Chuang,Han-Chung Hu,Shih-Wei Lin,Ying-Huang Tsai,Meng-Jer Hsieh,Cheng-Ta Yang,Ning-Hung Chen

doi:10.3390/ijerph18137080

Abstract

Patients with chronic obstructive pulmonary disease (COPD) have been reported to have poor sleep quality. However, total sleep time has not been evaluated in detail among patients with COPD. This retrospective, observational, multicenter research study was performed across six participating hospitals in Taiwan, with a total of 421 adult patients enrolled. Pulmonary function, the Modified British Medical Research Council Dyspnea Scale, the COPD Assessment Test and basic clinical data were assessed. The Pittsburgh Sleep Quality Index was also administered to patients, and the total sleep time was extracted for further analysis. The patients whose total sleep time was between 6 and 7 h had better pulmonary function, and the patients who slept less than 5 h had worse comorbidities. There was a significant higher total sleep time in Global Initiatives for Chronic Obstructive Lung Disease (GOLD) group B compared to GOLD group A. COPD patients who sleep between 5 and 6 h used fewer oral steroids and were less likely to use triple therapy (long-acting beta-agonist, long-acting muscarinic antagonist, inhaled cortical steroid). COPD patients sleeping from 5 to 7 h had better clinical features than those sleeping less than 5 h in terms of pulmonary function, comorbidities and medication usage.

Highlights

Sleep quality is impaired in patients with chronic obstructive pulmonary disease (COPD), as these patients have higher levels of sleep fragmentation and decreased slowwave and rapid-eye movement (REM) stages [1,2]
Our study revealed that COPD patients who sleep less than 5 h have a higher percentage of metabolic diseases, such as diabetes, dyslipidemia and osteoporosis, but not hypertension or cardiac disease
Our study showed that COPD patients who sleep between 5 and 6 h seem to take less maintenance inhaled triple therapy (LABA + LAMA + ICS) and fewer oral steroids

Summary

Introduction

Sleep quality is impaired in patients with chronic obstructive pulmonary disease (COPD), as these patients have higher levels of sleep fragmentation and decreased slowwave and rapid-eye movement (REM) stages [1,2]. Night-time symptoms have been reported incrementally with the severity of airflow limitation in COPD patients [3]. Oxygen desaturation often occurs during sleep in COPD patients with less REM sleep and arousal during that period [2]. Some studies have shown that COPD patients suffer from hypoxemia during sleep at a higher level than during exercise [8]. In patients with COPD, the severity of nocturnal oxygen desaturation and airflow limitation, presented with forced expiratory volume in the first second (FEV1 ) were weakly correlated with sleep quality [9,10]

Objectives

Methods

Results

Discussion

Conclusion