Daytime Symptoms of Chronic Obstructive Pulmonary Disease: a Systematic Review

Overview

Journal NPJ Prim Care Respir Med

Specialties Public Health
Pulmonary Medicine

Date 2020 Feb 22

PMID 32081967

Citations 11

Authors

Ioanna Tsiligianni

Janwillem W H Kocks

Affiliations

Soon will be listed here.

Abstract

There is no single source of compiled data on symptoms experienced by patients with chronic obstructive pulmonary disease (COPD) when awake and active throughout the day. The aim of this systematic review was to evaluate the prevalence, variability, and burden (i.e., bothersomeness and/or intensity), and the impact of daytime COPD symptoms on other outcomes. The review also evaluated the impact of interventions and the measures/tools used to assess daytime COPD symptoms in patients. A systematic literature search was conducted using the primary search terms "COPD", "symptoms", and "daytime" in EMBASE®, MEDLINE®, MEDLINE® In-Process, and CENTRAL in 2016, followed by an additional search in 2018 to capture any new literature that was published since the last search. Fifty-six articles were included in the review. The accumulated evidence indicated that the symptomatic burden of COPD appears greatest in the morning, particularly upon waking, and that these morning symptoms have a substantial impact on patients' ability to function normally through the day; they also worsen quality of life. A wide variety of tools were used to evaluate symptoms across the studies. The literature also confirmed the importance of pharmacotherapy in the management of daytime COPD symptoms, and in helping normalize daily functioning. More research is needed to better understand how COPD symptoms impact daily functioning and to evaluate COPD symptoms at well-defined periods throughout the day, using validated and uniform measures/tools. This will help clinicians to better define patients' needs and take appropriate action.

Citing Articles

Immunological Insights and Therapeutic Advances in COPD: Exploring Oral Bacterial Vaccines for Immune Modulation and Clinical Improvement.

Lewicki S, Balan B, Stelmasiak M, Radomska-Lesniewska D, Szymanski L, Rios-Turek N Vaccines (Basel). 2025; 13(2).

PMID: 40006655 PMC: 11861055. DOI: 10.3390/vaccines13020107.

Chronobiology in breathlessness across 24 h in people with persistent breathlessness.

Sandberg J, Sundh J, Anderberg P, Johnson M, Currow D, Ekstrom M ERJ Open Res. 2025; 11(1).

PMID: 39872384 PMC: 11770691. DOI: 10.1183/23120541.00417-2024.

The effects of camel milk in systemic inflammation and oxidative stress of cigarette smoke-induced chronic obstructive pulmonary disease model in rat.

Behrouz S, Mohammadi M, Sarir H, Boskabady M Front Vet Sci. 2024; 11:1464432.

PMID: 39735585 PMC: 11673985. DOI: 10.3389/fvets.2024.1464432.

Measuring burden of disease in both asthma and COPD by merging the ACQ and CCQ: less is more?.

Cuperus L, van Zelst C, Kerstjens H, Hendriks R, Molken M, Muilwijk-Kroes J NPJ Prim Care Respir Med. 2024; 34(1):8.

PMID: 38702303 PMC: 11068875. DOI: 10.1038/s41533-024-00364-z.

The six-minute step test can predict COPD exacerbations: a 36-month follow-up study.

Santos-de-Araujo A, da Luz Goulart C, Marinho R, Dourado I, Mendes R, Roscani M Sci Rep. 2024; 14(1):3649.

PMID: 38351306 PMC: 10864352. DOI: 10.1038/s41598-024-54338-9.

References

DUrzo A, De Salvo M, Ramirez-Rivera A, Almeida J, Sichletidis L, Rapatz G . In patients with COPD, treatment with a combination of formoterol and ipratropium is more effective than a combination of salbutamol and ipratropium : a 3-week, randomized, double-blind, within-patient, multicenter study. Chest. 2001; 119(5):1347-56. DOI: 10.1378/chest.119.5.1347. View

Ulrik C . Efficacy of inhaled salmeterol in the management of smokers with chronic obstructive pulmonary disease: a single centre randomised, double blind, placebo controlled, crossover study. Thorax. 1995; 50(7):750-4. PMC: 474647. DOI: 10.1136/thx.50.7.750. View

McCarley C, Hanneman S, Padhye N, Smolensky M . A pilot home study of temporal variations of symptoms in chronic obstructive lung disease. Biol Res Nurs. 2007; 9(1):8-20. DOI: 10.1177/1099800407303501. View

Roche N, Chavannes N, Miravitlles M . COPD symptoms in the morning: impact, evaluation and management. Respir Res. 2013; 14:112. PMC: 3816156. DOI: 10.1186/1465-9921-14-112. View

Partridge M, Miravitlles M, Stahl E, Karlsson N, Svensson K, Welte T . Development and validation of the Capacity of Daily Living during the Morning questionnaire and the Global Chest Symptoms Questionnaire in COPD. Eur Respir J. 2009; 36(1):96-104. DOI: 10.1183/09031936.00123709. View

Miravitlles M, Chapman K, Chuecos F, Ribera A, Garcia Gil E . The efficacy of aclidinium/formoterol on lung function and symptoms in patients with COPD categorized by symptom status: a pooled analysis. Int J Chron Obstruct Pulmon Dis. 2016; 11:2041-53. PMC: 5012634. DOI: 10.2147/COPD.S114566. View

Reisner C, Gottschlich G, Fakih F, Koser A, Krainson J, Delacruz L . 24-h bronchodilation and inspiratory capacity improvements with glycopyrrolate/formoterol fumarate via co-suspension delivery technology in COPD. Respir Res. 2017; 18(1):157. PMC: 5563048. DOI: 10.1186/s12931-017-0636-4. View

Agusti A, Hedner J, Marin J, Barbe F, Cazzola M, Rennard S . Night-time symptoms: a forgotten dimension of COPD. Eur Respir Rev. 2011; 20(121):183-94. PMC: 9584119. DOI: 10.1183/09059180.00004311. View

Jones P, Leidy N, Hareendran A, Lamarca R, Chuecos F, Garcia Gil E . The effect of aclidinium bromide on daily respiratory symptoms of COPD, measured using the Evaluating Respiratory Symptoms in COPD (E-RS: COPD) diary: pooled analysis of two 6-month Phase III studies. Respir Res. 2016; 17(1):61. PMC: 4877996. DOI: 10.1186/s12931-016-0372-1. View

10.

Petty T . Circadian variations in chronic asthma and chronic obstructive pulmonary disease. Am J Med. 1988; 85(1B):21-3. DOI: 10.1016/0002-9343(88)90237-9. View

11.

Donohue J, Kalberg C, Emmett A, Merchant K, Knobil K . A short-term comparison of fluticasone propionate/salmeterol with ipratropium bromide/albuterol for the treatment of COPD. Treat Respir Med. 2004; 3(3):173-81. DOI: 10.2165/00151829-200403030-00005. View

12.

von Haehling S, Anker S . Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle. 2011; 1(1):1-5. PMC: 3060651. DOI: 10.1007/s13539-010-0002-6. View

13.

R van Buul A, Kasteleyn M, Chavannes N, Taube C . Association between morning symptoms and physical activity in COPD: a systematic review. Eur Respir Rev. 2017; 26(143). PMC: 9488459. DOI: 10.1183/16000617.0033-2016. View

14.

Sundar I, Yao H, Sellix M, Rahman I . Circadian molecular clock in lung pathophysiology. Am J Physiol Lung Cell Mol Physiol. 2015; 309(10):L1056-75. PMC: 4652147. DOI: 10.1152/ajplung.00152.2015. View

15.

McGarvey L, Morice A, Smith J, Birring S, Chuecos F, Seoane B . Effect of aclidinium bromide on cough and sputum symptoms in moderate-to-severe COPD in three phase III trials. BMJ Open Respir Res. 2017; 3(1):e000148. PMC: 5174811. DOI: 10.1136/bmjresp-2016-000148. View

16.

DUrzo A, Rennard S, Kerwin E, Mergel V, Leselbaum A, Caracta C . Efficacy and safety of fixed-dose combinations of aclidinium bromide/formoterol fumarate: the 24-week, randomized, placebo-controlled AUGMENT COPD study. Respir Res. 2015; 15:123. PMC: 4213545. DOI: 10.1186/s12931-014-0123-0. View

17.

Vincken W, Aumann J, Chen H, Henley M, McBryan D, Goyal P . Efficacy and safety of coadministration of once-daily indacaterol and glycopyrronium versus indacaterol alone in COPD patients: the GLOW6 study. Int J Chron Obstruct Pulmon Dis. 2014; 9:215-28. PMC: 3940646. DOI: 10.2147/COPD.S51592. View

18.

DUrzo A, Kerwin E, Overend T, DAndrea P, Chen H, Goyal P . Once daily glycopyrronium for the treatment of COPD: pooled analysis of the GLOW1 and GLOW2 studies. Curr Med Res Opin. 2013; 30(3):493-508. DOI: 10.1185/03007995.2013.858618. View

19.

Borsboom G, Van Pelt W, van Houwelingen H, van Vianen B, Schouten J, Quanjer P . Diurnal variation in lung function in subgroups from two Dutch populations: consequences for longitudinal analysis. Am J Respir Crit Care Med. 1999; 159(4 Pt 1):1163-71. DOI: 10.1164/ajrccm.159.4.9703106. View

20.

Kostikas K, Aalamian-Mattheis M, Pagano V, Nunez X, Fogel R, Patalano F . Early Changes in eDiary COPD Symptoms Predict Clinically Relevant Treatment Response at 12 Weeks: Analysis from the CRYSTAL Study. COPD. 2018; 15(2):185-191. DOI: 10.1080/15412555.2018.1445213. View