Sleep Quality in COPD Patients; Incidence and Predictors of Poor Quality

Abstract
Objectives: Evaluation of sleep quality in COPD and relationship of PSQI (Pittsburgh Sleep Quality Index) score with health related quality of life, depression, anxiety and severity of airflow obstruction.
Patients and Methods: A prospective study of 124 COPD patients, 42 adult control. All completed PFT, ABG, routine investigation. All were age and gender matched. Quality of sleep measured by Pittsburgh Sleep Quality Index (PSQI). Health related quality of life was measured by diseasespecific (St. George's Respiratory) questionnaires. Anxiety, depression assessed by Hamilton scale and Beck's depression inventory.
Results: 53.2% of COPD patients had poor sleep quality, 50% had high risk of OSA with statistically significant differ-ence regarding smoking index, spirometric parameters, 6-min walk test, Berlin questionnaire, PSQI, ESS, BDI and HAM-A. COPD poor sleep quality had statistically higher, number of exacerbations, total SGRQ (St.George respiratory question-naire), ESS (Epworth sleepiness scale), BDI, HAM-A. COPD patients with high risk of OSA had statistically significant number of exacerbations, shorter 6-min walk test and higher total SGRQ, ESS, PSQI, BDI and HAM-A. No relation be-tween disease severity and sleep disturbance, health related quality of life. PSQI was correlated positively with COPD duration, number of exacerbation, PCO2, HAM-A (Hamilton Anxiety Rating Scale), BDI (Beck's Depression Inventory) and SGRQ. PSQI was correlated negatively with FEV1, FVC%, FEF25-75%, use of (long acting muscarinic antago-nists).
Conclusion: COPD is associated with poor sleep quality and high risk of OSA. Strong association between poor sleep quality and physical limitation, anxiety, depression and poor health related quality of life.