First Department of Pulmonary Medicine and Intensive Care Unit, National and Kapodistrian University of Athens, Medical School, 115 27, Athens, Greece.
5Th Respiratory Medicine Department, General Hospital for Chest Diseases of Athens "SOTIRIA", Athens, Greece.
Sci Rep. 2022 Jan 11;12(1):540. doi: 10.1038/s41598-021-04610-z.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide accompanied by a substantial social and economic burden for the patient and the society. Poor sleep quality among COPD patients is frequently unnoticed and unaddressed by physicians and patients themselves, although it is a major source of further deterioration of these patients' quality of life. The aim of the present study was to record the quality of sleep in COPD patients among the Greek population and correlate these findings with various features of these patients, using the COPD and Asthma Sleep Impact Scale (CASIS). This was a cross-sectional observational study. Forty different variables (demographics, vital sign measurements, COPD-related medical history parameters, comorbidities, CASIS questionnaire results, COPD assessment test, COPD severity based on spirometry measurements, COPD stage based on the ABCD assessment approach, inhaled COPD treatment report) were collected from 3454 nation-wide COPD patients (Greece). The study sample consisted of COPD patients, mainly male (73%) with a median age of 69 years and a median BMI of 27.2. More than half of COPD patients (60.6%) suffered from moderate disease severity and 23.8% from severe disease, while less than half (42.1%) suffered from at least one exacerbation of the disease over the last year prior study enrollment. About 14% reported frequent to very frequent issues affecting their sleep quality, between a fourth and a third of them reported occasional night sleep disturbances, and at least half of them reported no or very infrequent problems in their night sleep. Our study indicates that the COPD assessment test (CAT) and the spirometry-based disease severity can predict the poorness in the quality of sleep (F = 1397.5, p < 0.001, adj. R2 = 0.45) as assessed by CASIS score, and that the latter also correlates with age (ρ = 0.122, p < 0.001) and disease duration (ρ = 0.104, p < 0.001). On the contrary, there appears to be no correlation between sleep quality and number of exacerbations. Finally, untreated patients with COPD suffer from poorer quality of sleep compared to treated subjects, independently of the use of inhaled corticosteroids (F = 21.65, p < 0.001). The results of the SLEPICO study show that increased age, prolonged disease duration, and especially CAT score ≥ 10, and severe COPD stage, might act as important indicators for deterioration in the quality of sleep, with potential consequences in the daily routine of those patients, thus urging potentially for further pharmacological interventions or modifications.
慢性阻塞性肺疾病（COPD）是全球发病率和死亡率的主要原因，给患者和社会带来了巨大的社会和经济负担。尽管睡眠质量差是 COPD 患者生活质量进一步恶化的主要来源，但医生和患者本身经常没有注意到这一点，也没有加以解决。本研究的目的是记录希腊人群中 COPD 患者的睡眠质量，并使用 COPD 和哮喘睡眠影响量表（CASIS）将这些发现与这些患者的各种特征相关联。这是一项横断面观察性研究。从 3454 名全国 COPD 患者（希腊）中收集了 40 个不同的变量（人口统计学、生命体征测量、COPD 相关病史参数、合并症、CASIS 问卷结果、COPD 评估测试、基于肺活量测定的 COPD 严重程度、基于 ABCD 评估方法的 COPD 阶段、吸入性 COPD 治疗报告）。研究样本包括 COPD 患者，主要为男性（73%），中位年龄为 69 岁，中位 BMI 为 27.2。超过一半的 COPD 患者（60.6%）患有中度疾病严重程度，23.8%患有重度疾病，而不到一半（42.1%）在研究入组前一年至少患有一次疾病加重。约 14%的患者报告经常到非常频繁地影响他们睡眠质量的问题，四分之一到三分之一的患者报告偶尔夜间睡眠障碍，至少一半的患者报告夜间睡眠没有或很少有问题。我们的研究表明，COPD 评估测试（CAT）和基于肺活量的疾病严重程度可以预测 CASIS 评分评估的睡眠质量差（F=1397.5，p<0.001，调整后的 R2=0.45），后者还与年龄（ρ=0.122，p<0.001）和疾病持续时间（ρ=0.104，p<0.001）相关。相反，睡眠质量与加重次数之间似乎没有相关性。最后，与接受治疗的患者相比，未接受治疗的 COPD 患者的睡眠质量较差，而与吸入皮质类固醇的使用无关（F=21.65，p<0.001）。SLEPICO 研究的结果表明，年龄增长、疾病持续时间延长，尤其是 CAT 评分≥10 和严重的 COPD 阶段，可能是睡眠质量恶化的重要指标，可能对这些患者的日常生活产生潜在影响，因此迫切需要进一步的药物干预或修改。
