The Effect of Sleep Impairment, As Assessed by the CASIS Questionnaire, in Patients with Chronic Obstructive Pulmonary Disease on Disease Severity and Physical and Mental Health: A Cross-Sectional Study in Primary Care

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2024 Aug 29

PMID 39200109

Authors

Izolde Bouloukaki

Antonios Christodoulakis

Katerina Margetaki

Ioanna Tsiligianni

Affiliations

Soon will be listed here.

Abstract

The aim of our study was to assess the prevalence of sleep impairment among primary care patients with COPD and explore its impact on disease severity and overall health status. This cross-sectional study included 251 participants > 40 years old from the prospective COCARE COPD study. Data on sociodemographic characteristics, medical history, disease-specific quality of life [COPD Assessment Test (CAT)], COPD severity [Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 categorization based on CAT score and exacerbations], fatigue [Fatigue Severity Scale (FSS)], psychological parameters [Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7)], and sleep complaints [COPD and Asthma Sleep Impact Scale (CASIS) and Epworth Sleepiness Scale (ESS)] were collected. Multiple logistic regression analysis was conducted to test for associations of sleep impairment with COPD and overall health status, adjusting for confounders. Sleep impairment, indicated by a CASIS score ≥ 30, increased the risk of worse COPD health status (CAT ≥ 10 OR: 9.7, 95% CI: 5-19, < 0.001), COPD severity (GOLD B OR: 8.9, 95% CI: 4.5-17.6, < 0.001 and GOLD E OR: 17.4, 95% CI: 5.1-59.4, < 0.001), excessive daytime sleepiness (ESS > 10, OR: 3.2, 95% CI: 1.3-8.1, = 0.012), depressive symptoms (PHQ-9 ≥ 10, OR: 6.4, 95% CI: 2.1-19.1, = 0.001), anxiety symptoms (GAD-7 ≥ 10, OR: 3.9, 95% CI: 1.6-9.2, = 0.002), and fatigue (FSS ≥ 36, OR: 5.3, 95% CI: 2.8-9.8, < 0.001). In conclusion, our findings suggest that sleep impairment, based on the CASIS questionnaire, is associated with worse physical and mental health in patients with COPD. Therefore, through consistent evaluation of sleep and targeted management strategies, healthcare providers could improve the quality of life for these patients.

References

Chen R, Tian J, Zhou L, Chen X, Yan H, Zeng B . The relationship between sleep quality and functional exercise capacity in COPD. Clin Respir J. 2014; 10(4):477-85. DOI: 10.1111/crj.12249. View

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

Aldabayan Y . Mental health and sleep quality among patients with asthma and COPD. Front Med (Lausanne). 2023; 10:1181742. PMC: 10203504. DOI: 10.3389/fmed.2023.1181742. View

Kruis A, Stallberg B, Jones R, Tsiligianni I, Lisspers K, van der Molen T . Primary care COPD patients compared with large pharmaceutically-sponsored COPD studies: an UNLOCK validation study. PLoS One. 2014; 9(3):e90145. PMC: 3943905. DOI: 10.1371/journal.pone.0090145. View

Soldatos C, Dikeos D, Paparrigopoulos T . Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000; 48(6):555-60. DOI: 10.1016/s0022-3999(00)00095-7. View

Budhiraja R, Parthasarathy S, Budhiraja P, Habib M, Wendel C, Quan S . Insomnia in patients with COPD. Sleep. 2012; 35(3):369-75. PMC: 3274338. DOI: 10.5665/sleep.1698. View

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

Gupta A, Garg K, Chopra V, Singh S . Assessment of health status and its correlation with lung function in patients with chronic obstructive pulmonary disease: a study from a tertiary care center in north India. Monaldi Arch Chest Dis. 2023; 94(1). DOI: 10.4081/monaldi.2023.2530. View

Clark L, Klinedinst N, Zhu S, Seong H, Reed R, Renn C . Factors Related to Fatigue and Physical Function in COPD: A Secondary Analysis Using National Survey Data. West J Nurs Res. 2023; 45(7):653-664. DOI: 10.1177/01939459231170710. View

10.

Ozer Z, Bahcecioglu Turan G, Aksoy M . The effects of yoga on dyspnea, sleep and fatigue in chronic respiratory diseases. Complement Ther Clin Pract. 2021; 43:101306. DOI: 10.1016/j.ctcp.2021.101306. View

11.

Fei F, Koffman J, Zhang X, Gao W . Chronic Obstructive Pulmonary Disease Symptom Cluster Composition, Associated Factors, and Methodologies: A Systematic Review. West J Nurs Res. 2021; 44(4):395-415. PMC: 8894625. DOI: 10.1177/0193945921995773. View

12.

Hyphantis T, Kotsis K, Voulgari P, Tsifetaki N, Creed F, Drosos A . Diagnostic accuracy, internal consistency, and convergent validity of the Greek version of the patient health questionnaire 9 in diagnosing depression in rheumatologic disorders. Arthritis Care Res (Hoboken). 2011; 63(9):1313-21. DOI: 10.1002/acr.20505. View

13.

Basile M, Baiamonte P, Mazzuca E, Principe S, Pennavaria F, Benfante A . Sleep Disturbances in COPD are Associated with Heterogeneity of Airway Obstruction. COPD. 2018; 15(4):350-354. DOI: 10.1080/15412555.2018.1504015. View

14.

Tsiligianni I, van der Molen T, Moraitaki D, Lopez I, Kocks J, Karagiannis K . Assessing health status in COPD. A head-to-head comparison between the COPD assessment test (CAT) and the clinical COPD questionnaire (CCQ). BMC Pulm Med. 2012; 12:20. PMC: 3431277. DOI: 10.1186/1471-2466-12-20. View

15.

Ebadi Z, Goertz Y, Van Herck M, Janssen D, Spruit M, Burtin C . The prevalence and related factors of fatigue in patients with COPD: a systematic review. Eur Respir Rev. 2021; 30(160). PMC: 9489028. DOI: 10.1183/16000617.0298-2020. View

16.

Kapella M, Herdegen J, Perlis M, Shaver J, Larson J, Law J . Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects. Int J Chron Obstruct Pulmon Dis. 2011; 6:625-35. PMC: 3232169. DOI: 10.2147/COPD.S24858. View

17.

Banks S, Dinges D . Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med. 2007; 3(5):519-28. PMC: 1978335. View

18.

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

19.

Clark L, Reed R, Corazzini K, Zhu S, Renn C, Klinedinst N . COPD-Related Fatigue: A Scoping Review. Clin Nurs Res. 2022; 32(5):914-928. DOI: 10.1177/10547738221141224. View

20.

Antonelli Incalzi R, Blasi F, Scichilone N, Zullo A, Simoni L, Canonica G . One-Year Evolution of Symptoms and Health Status of the COPD Multi-Dimensional Phenotypes: Results from the Follow-Up of the STORICO Observational Study. Int J Chron Obstruct Pulmon Dis. 2021; 16:1007-1020. PMC: 8071085. DOI: 10.2147/COPD.S289697. View