Ali Zohal Mohammad, Yazdi Zohreh, Kazemifar Amir Mohammad
Qazvin University of Medical Sciences, Qazvin, Iran.
Glob J Health Sci. 2013 Feb 25;5(3):150-5. doi: 10.5539/gjhs.v5n3p150.
Chronic obstructive pulmonary disease (COPD) is a widespread disease. It produces some night symptoms such as nighttime cough and dyspnea. Then subjective and objective changes in sleep pattern are expected. Present study was conducted to determine frequency of sleepiness and quality of sleep in patients with COPD.
MATERIALS & METHODS: Present case-control study has been performed on 120 patients with diagnosis of COPD who had been referred to pulmonary disease clinic in a University teaching hospital. One hundred twenty age- and sex- matched healthy individuals were recruited in the study and served as control. Spirometry (PFT) was performed for all patients. Patients were categorized under 3 groups in relation to their PFT as follow: mild COPD (FEV1/FVC<70% and >=80%), moderate COPD (FEV1/FVC<70% and 50%<=FEV1<80%), and severe COPD (FEV1/FVC<70% and FEV1<50%). Pittsburgh Sleep Quality questionnaire (PSQI) and Epworth Sleepiness Scale (ESS) were used to estimate quality of sleep and daytime sleepiness in the patients and control group. The collected data were analyzed using version 16 SPSS software. Student's T- test, Chi- square and multiple logistic regressions were used as appropriated.
120 patients with COPD (79 males and 41 females) and 120 normal individuals responded to the questionnaires. Mean scores of quality of sleep were 8.03±3.66 and 4.2±2.8 in COPD patients and control group respectively. 32.1% of the patients had good sleep quality (PSQI score less than 5) and 67.9% had poor sleep quality. Daytime sleepiness (ESS>=10) was present in 34.8% of the patients and 15% of control people. Multiple logistic regressions showed that the patients reported significantly worse sleep quality and more daytime sleepiness than control group [OR=2.9; 95% CI (1.6-3.7) & OR=3.5; 95% CI (2.5-4.3) respectively].
Results of present study confirmed that COPD is associated with daytime sleepiness and poor quality of sleep, possibly attributable to nighttime respiratory difficulties and concomitant sleep apnea. Assessment of the patients for symptoms of sleep apnea, daytime sleepiness should be a part of regular follow up visits of patients with COPD.
慢性阻塞性肺疾病（COPD）是一种广泛流行的疾病。它会产生一些夜间症状，如夜间咳嗽和呼吸困难。进而预计会出现睡眠模式的主观和客观变化。本研究旨在确定COPD患者的嗜睡频率和睡眠质量。
本病例对照研究对120例诊断为COPD且已转诊至某大学教学医院肺病门诊的患者进行。研究招募了120名年龄和性别匹配的健康个体作为对照。对所有患者进行了肺功能测定（PFT）。根据患者的PFT将其分为3组，如下：轻度COPD（FEV1/FVC<70%且≥80%）、中度COPD（FEV1/FVC<70%且50%≤FEV1<80%）和重度COPD（FEV1/FVC<70%且FEV1<50%）。使用匹兹堡睡眠质量问卷（PSQI）和爱泼华嗜睡量表（ESS）来评估患者和对照组的睡眠质量和日间嗜睡情况。收集的数据使用SPSS 16版软件进行分析。适当使用了学生t检验、卡方检验和多元逻辑回归。
120例COPD患者（79例男性和41例女性）和120名正常个体对问卷进行了回复。COPD患者和对照组的睡眠质量平均得分分别为8.03±3.66和4.2±2.8。32.1%的患者睡眠质量良好（PSQI得分小于5），67.9%的患者睡眠质量较差。34.8%的患者存在日间嗜睡（ESS≥10），对照组为15%。多元逻辑回归显示，患者报告的睡眠质量明显比对照组差，日间嗜睡情况也更严重[OR分别为2.9；95%CI（1.6 - 3.7）和OR为3.5；95%CI（2.5 - 4.3）]。
本研究结果证实，COPD与日间嗜睡和睡眠质量差有关，可能归因于夜间呼吸困难和并发的睡眠呼吸暂停。对患者进行睡眠呼吸暂停症状、日间嗜睡的评估应成为COPD患者定期随访的一部分。
