Poor Sleep Quality, COPD Severity and Survival According to CASIS and Pittsburgh Questionnaires

Overview

Journal Sci Rep

Specialty Science

Date 2023 Nov 1

PMID 37907621

Authors

Julia Sampol

Marc Miravitlles

Maria Saez

Mercedes Pallero

Gabriel Sampol

Jaume Ferrer

Affiliations

Soon will be listed here.

Abstract

Poor sleep quality is frequent among COPD patients and it has been related to worse outcomes. The objective of this study was to compare the COPD and Asthma Sleep Impact Scale (CASIS) and the generic Pittsburgh Sleep Quality Index (PSQI) questionnaires as reliable tools for evaluating sleep quality and its relationship with COPD characteristics and survival. Stable COPD patients were prospectively evaluated. Anthropometric, sociodemographic, comorbidity, lung function and treatment data were collected. All patients completed CASIS and PSQI, mMRC dyspnea severity scale, COPD Assessment Test (CAT), sleep apnoea STOP-Bang and Hospital Anxiety and Depression Scale (HADS) questionnaires. Body mass index, airflow Obstruction, Dyspnea and Exacerbations (BODEx) index was calculated. Life status was determined after a mean follow-up of 3.7 (SD 1) years. We included 200 patients, 69.5% male, mean age 65.8 (9) years. Poor sleep was detected in 100 (50%) and 84 patients (42%) according to PSQI and CASIS questionnaires, respectively, with an agreement of 63%. Poor sleep was related to female gender, more severe dyspnea and worse BODEx, HADS and CAT scores according to both questionnaires. PSQI was associated to chronic pain or inferior urinary tract symptoms and CASIS to exacerbations, shorter walked distance in the 6-min walking test and treatment with oral corticosteroids or chronic oxygen. Thirty nine (19.5%) patients died during follow-up. Mortality was not associated to PSQI nor CASIS results. Unlike PSQI, CASIS is more related to COPD severity and its results are not influenced by comorbidities with known impact on sleep quality. In our sample, poor sleep quality was not associated with increased mortality.

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References

Omachi T, Blanc P, Claman D, Chen H, Yelin E, Julian L . Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. Sleep Med. 2012; 13(5):476-83. PMC: 3336048. DOI: 10.1016/j.sleep.2011.12.007. View

Nunes D, Mota R, de Pontes Neto O, Pereira E, de Bruin V, de Bruin P . Impaired sleep reduces quality of life in chronic obstructive pulmonary disease. Lung. 2009; 187(3):159-63. DOI: 10.1007/s00408-009-9147-5. View

Ierodiakonou D, Bouloukaki I, Kampouraki M, Papadokostakis P, Poulorinakis I, Lampraki I . Subjective sleep quality is associated with disease status in COPD patients. The cross-sectional Greek UNLOCK study. Sleep Breath. 2020; 24(4):1599-1605. DOI: 10.1007/s11325-020-02039-8. View

Zigmond A, SNAITH R . The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361-70. DOI: 10.1111/j.1600-0447.1983.tb09716.x. View

Lee S, Kim K, Lee H, Park H, Kim Y, Lee M . Sleep disturbance in patients with mild-moderate chronic obstructive pulmonary disease. Clin Respir J. 2019; 13(12):751-757. DOI: 10.1111/crj.13085. View

Miravitlles M, Luis Izquierdo J, Esquinas C, Perez M, Calle M, Lopez-Campos J . The variability of respiratory symptoms and associated factors in COPD. Respir Med. 2017; 129:165-172. DOI: 10.1016/j.rmed.2017.06.017. View

McCarter S, Hagen P, St Louis E, Rieck T, Haider C, Holmes D . Physiological markers of sleep quality: A scoping review. Sleep Med Rev. 2022; 64:101657. DOI: 10.1016/j.smrv.2022.101657. View

Minassian V, Yan X, Lichtenfeld M, Sun H, Stewart W . The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J. 2012; 23(8):1087-93. PMC: 3905313. DOI: 10.1007/s00192-012-1743-x. 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

10.

Blanco I, Diego I, Bueno P, Casas-Maldonado F, Miravitlles M . Geographic distribution of COPD prevalence in the world displayed by Geographic Information System maps. Eur Respir J. 2019; 54(1). DOI: 10.1183/13993003.00610-2019. View

11.

Lehmann S, Ringbaek T, Lokke A, Grote L, Hedner J, Lindberg E . A randomized trial to determine the impact of indacaterol/glycopyrronium on nighttime oxygenation and symptoms in patients with moderate-to-severe COPD: the DuoSleep study. Int J Chron Obstruct Pulmon Dis. 2019; 14:199-210. PMC: 6330967. DOI: 10.2147/COPD.S184127. View

12.

Lopez-Campos J . [Importance of fatigue, sleep quality and mood in patients with chronic obstructive pulmonary disease and the need for measurement instruments]. Arch Bronconeumol. 2010; 45 Suppl 5:2-6. DOI: 10.1016/S0300-2896(09)72948-5. View

13.

Hynninen M, Bjerke N, Pallesen S, Bakke P, Nordhus I . A randomized controlled trial of cognitive behavioral therapy for anxiety and depression in COPD. Respir Med. 2010; 104(7):986-94. DOI: 10.1016/j.rmed.2010.02.020. View

14.

Parthasarathy S, Vasquez M, Halonen M, Bootzin R, Quan S, Martinez F . Persistent insomnia is associated with mortality risk. Am J Med. 2014; 128(3):268-75.e2. PMC: 4340773. DOI: 10.1016/j.amjmed.2014.10.015. View

15.

Agusti A, Celli B, Criner G, Halpin D, Anzueto A, Barnes P . Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Eur Respir J. 2023; 61(4). PMC: 10066569. DOI: 10.1183/13993003.00239-2023. View

16.

Li Y, Zhang X, Winkelman J, Redline S, Hu F, Stampfer M . Association between insomnia symptoms and mortality: a prospective study of U.S. men. Circulation. 2013; 129(7):737-46. PMC: 3987964. DOI: 10.1161/CIRCULATIONAHA.113.004500. View

17.

Taylor B, Wilt T, Fink H, Lambert L, Marshall L, Hoffman A . Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology. 2006; 68(4):804-9. DOI: 10.1016/j.urology.2006.04.019. View

18.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

19.

Zeidler M, Martin J, Kleerup E, Schneider H, Mitchell M, Hansel N . Sleep disruption as a predictor of quality of life among patients in the subpopulations and intermediate outcome measures in COPD study (SPIROMICS). Sleep. 2018; 41(5). PMC: 5946919. DOI: 10.1093/sleep/zsy044. View

20.

Soler-Cataluna J, Martinez-Garcia M, Sanchez L, Perpina Tordera M, Roman Sanchez P . Severe exacerbations and BODE index: two independent risk factors for death in male COPD patients. Respir Med. 2009; 103(5):692-9. DOI: 10.1016/j.rmed.2008.12.005. View