Department of Clinical Psychology, University of Bergen, Christies Gate 12, 5015 Bergen, Norway; NKS Olaviken, Hospital for Old Age Psychiatry, Askvegen 150, 5306 Erdal, Norway.
Sleep Med. 2013 Dec;14(12):1328-33. doi: 10.1016/j.sleep.2013.08.785. Epub 2013 Oct 14.
Sleep disturbances are known to have a negative impact on a range of clinical outcomes in chronic obstructive pulmonary disease (COPD). We examined the associations of insomnia symptoms and objectively measured sleep parameters to a composite score for body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index (a multidimensional index of COPD severity), arterial blood gases, nocturnal respiratory disturbances, periodic limb movements (PLM), psychologic distress, pain, age, and sex.
The sample comprised 73 COPD outpatients (mean age, 63.6years; standard deviation {SD}, 7.5; range 47-85years; 41.1% women). Insomnia symptoms were measured with the Bergen Insomnia Scale (BIS) and sleep efficiency (SE), slow-wave sleep (SWS), and total sleep time (TST) were assessed with clinical polysomnography (PSG).
BODE index was positively associated with composite BIS score (P=.040). Patients with more severe COPD presented more complaints of nonrestorative sleep compared to patients with less severe COPD (P=.010). In multivariate analysis, the composite BIS score was independently associated with PLM (P<.001), nocturnal respiratory disturbances (P=.001), pain (P=.031), and psychologic distress (P=.044) but not with the BODE index. Objectively measured sleep variables were not associated with any of the health-related variables.
Insomnia symptoms in COPD patients result from a wide range of health-related factors. More severe COPD may be associated with a subjective experience of nonrestorative sleep but not with objectively measured sleep variables.
睡眠障碍已知对慢性阻塞性肺疾病（COPD）的一系列临床结果有负面影响。我们研究了失眠症状和客观测量的睡眠参数与身体质量指数、气流阻塞、呼吸困难和运动能力（BODE）指数（COPD 严重程度的多维指数）、动脉血气、夜间呼吸障碍、周期性肢体运动（PLM）、心理困扰、疼痛、年龄和性别的综合评分之间的关联。
该样本包括 73 名 COPD 门诊患者（平均年龄 63.6 岁；标准差{SD} 7.5；范围 47-85 岁；41.1%为女性）。失眠症状用 Bergen 失眠量表（BIS）测量，睡眠效率（SE）、慢波睡眠（SWS）和总睡眠时间（TST）用临床多导睡眠图（PSG）评估。
BODE 指数与复合 BIS 评分呈正相关（P=.040）。与 COPD 较轻的患者相比，COPD 较重的患者对非恢复性睡眠的抱怨更多（P=.010）。在多变量分析中，复合 BIS 评分与 PLM（P<.001）、夜间呼吸障碍（P=.001）、疼痛（P=.031）和心理困扰（P=.044）独立相关，但与 BODE 指数无关。客观测量的睡眠变量与任何健康相关变量均无关。
COPD 患者的失眠症状是由广泛的健康相关因素引起的。更严重的 COPD 可能与主观上的非恢复性睡眠体验相关，但与客观测量的睡眠变量无关。
