Sleep quality in COPD patients: correlation with disease severity and health status

• Published in: Jornal brasileiro de pneumologia Vol. 48; no. 3; p. e20210340
• Main Authors: Clímaco, Danielle Cristina Silva, Lustosa, Thais C, Silva, Marcus Vinícius de França Pereira, Lins-Filho, Ozeas L, Rodrigues, Valesca Kehrle, Oliveira-Neto, Luiz de Albuquerque P de, Feitosa, Audes Diógenes Magalhães, Queiroga, Jr, Fernando José Pinho, Cabral, Marília Montenegro, Pedrosa, Rodrigo P
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Pneumologia e Tisiologia 01-01-2022
• Subjects: Aged; Humans; Middle Aged; Original; Pulmonary Disease, Chronic Obstructive - complications; Quality of Life; RESPIRATORY SYSTEM; Severity of Illness Index; Sleep Apnea, Obstructive - complications; Sleep Quality; Doença pulmonar obstrutiva crônica; Nível de saúde; Health status; Qualidade do sono; Sleep Quality; Apneia obstrutiva do sono; Pulmonary disease, chronic obstructive; Sleep apnea, obstructive
• ISSN: 1806-3756; 1806-3713; 1806-3756
• DOI: 10.36416/1806-3756/e20210340

To evaluate clinical predictors of poor sleep quality in COPD patients with and without obstructive sleep apnea (OSA).
Consecutive stable patients with COPD were evaluated for OSA by means of overnight polysomnography; for sleep quality by means of the Pittsburgh Sleep Quality Index (PSQI); and for disease impact by means of the COPD Assessment Test. COPD severity was graded in accordance with the 2020 GOLD guidelines. Predictors of poor sleep quality were evaluated by multivariate logistic regression analysis.
We studied 51 patients with COPD alone and 51 patients with COPD and OSA. Both groups had similar age (66.2 ± 9.2 years vs. 69.6 ± 10.7, p = 0.09) and airflow limitation (p = 0.37). Poor sleep quality was present in 74.8% of the study participants, with no significant difference between COPD patients with and without OSA regarding PSQI scores (p = 0.73). Polysomnography showed increased stage 1 non-rapid eye movement sleep and arousal index, as well as reduced sleep efficiency and stage 3 non-rapid eye movement sleep, in the group of patients with COPD and OSA (p < 0.05). Independent predictors of poor sleep quality were GOLD grade C/D COPD (OR = 6.4; 95% CI, 1.79-23.3; p < 0.01), a COPD Assessment Test score ≥ 10 (OR = 12.3; 95% CI, 4.1-36.5; p < 0.01), and lowest SaO2 < 80% (p < 0.0001).
Poor sleep quality is quite common in patients with COPD and is associated with severe COPD and poor health status, having a negative impact on overall quality of life. Despite changes in polysomnography, OSA appears to have no impact on subjective sleep quality in COPD patients.