INSOMNIA IN PATIENTS WITH COPD
Insomnia in Patients with COPD
Rohit Budhiraja, MD1,2,3; Sairam Parthasarathy, MD1,2,3; Pooja Budhiraja, MD1,3; Michael P. Habib, MD1,2,3; Christopher Wendel, MS3,4; Stuart F. Quan, MD2,5
1Department of Medicine, Southern Arizona Veterans Affairs Health Care System (SAVAHCS), Tucson, AZ; 2Arizona Respiratory Center, The University of Arizona, Tucson, AZ; 3Department of Medicine, University of Arizona College of Medicine, Tucson, AZ; 4Research Service Line, Southern Arizona VA Health Care System, Tucson, AZ; 5Division of Sleep Medicine, Brigham and Womens Hospital and Harvard Medical School, Boston, MA
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be associated with sleep disturbances. However, the correlates of insomnia in COPD patients have not been well characterized. The aim of the current study was to describe the prevalence of insomnia disorder in COPD and to elucidate the demographic and clinical characteristics of COPD patients that are associated with insomnia.
Clinic-based sample from an academic hospital.
Patients with stable COPD.
An interviewer-conducted survey was administered to 183 participants with COPD. Seventy-two of these participants (30 with and 42 without insomnia) maintained a sleep diary and underwent actigraphy for 7 days.
Insomnia (chronic sleep disturbance associated with impaired daytime functioning) was present in 27.3% of participants. Current tobacco users (odds ratio (OR), 2.13) and those with frequent sadness/anxiety (OR, 3.57) had higher odds, but oxygen use was associated with lower odds (OR, 0.35) of insomnia. Patients with insomnia had worse quality of life and a higher prevalence of daytime sleepiness. Actigraphy revealed shorter sleep duration and lower sleep efficiency, and a sleep diary revealed worse self-reported sleep quality in participants with insomnia.
Insomnia disorder is highly prevalent in patients with COPD; current tobacco use and sadness/anxiety are associated with a higher prevalence, and oxygen use with a lower prevalence of insomnia; patients with insomnia have poorer quality of life and increased daytime sleepiness; and insomnia is associated with worse objective sleep quality.
Budhiraja R; Parthasarathy S; Budhiraja P; Habib MP; Wendel C; Quan SF. Insomnia in patients with COPD. SLEEP 2012;35(3):369-375.