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肌少症与慢性阻塞性肺疾病患者的睡眠。

Sarcopenia and sleep in individuals with chronic obstructive pulmonary disease.

机构信息

Laboratory of Research in Respiratory Physiotherapy, Departament of Physioterapy, Universidade Estadual de Londrina - Av, Robert Koch, 60 - Vila Operária, Londrina, Paraná, 86038-350, Brasil.

Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil.

出版信息

Sleep Breath. 2024 Dec;28(6):2557-2563. doi: 10.1007/s11325-024-03126-w. Epub 2024 Sep 17.

Abstract

OBJECTIVE

To verify the relationship between sarcopenia and sleep in individuals with chronic obstructive pulmonary disease (COPD).

METHODS

Individuals with COPD were cross-sectionally assessed for lung function (spirometry), sleep (both subjectively [Pittsburgh Sleep Quality Index, PSQI] and objectively [Actiwatch sleep monitor]) and the presence of sarcopenia (handgrip strength by dynamometry). All tests were carried out in accordance with international standards.

RESULTS

Twenty-nine individuals with COPD were analyzed (16 women; 69 ± 7 years; BMI 27 ± 5 kg/m; FEV 59 ± 19% predicted). Upon division in groups according to the presence or absence of sarcopenia, individuals with sarcopenia (in comparison to those without sarcopenia) had shorter sleep time (81 [75-85] vs. 86 [81-90] %; p = 0.043), lower sleep efficiency (77 [69-83] vs. 85 [75-87] %; p = 0.038), longer time awake after sleep onset (92 [71-120] vs. 58 [47-83] minutes; p = 0.0012) and more marked sleep fragmentation, represented by a higher number of sleep blocks/night (46 [41-49] vs. 34 [26-48]; p = 0.018), higher number of awake blocks/night (45 [40-49] vs. 34 [26-48]; p = 0.018) and shorter duration of sleep blocks/night (9 [8-10] vs. 14 [8-58] minutes; p = 0.043). There was no statistical difference when comparing the PSQI variables between the groups. However, handgrip strength was negatively associated with PSQI components 2 [R= -0.51, p = 0.005] and 5 [R= -0.39, p = 0.037].

CONCLUSION

Individuals with COPD and sarcopenia (as measured by handgrip strength) have worse objectively measured sleep outcomes. This was not the case regarding a self-reported perception of worse sleep quality, although there was weak-to-moderate association between handgrip strength and subjective sleep.

摘要

目的

验证慢性阻塞性肺疾病(COPD)患者的肌肉减少症与睡眠之间的关系。

方法

采用横断面研究评估 COPD 患者的肺功能(肺量计)、睡眠(主观[匹兹堡睡眠质量指数(PSQI)]和客观[活动手表睡眠监测仪])和肌肉减少症(通过测力计测量握力)。所有测试均符合国际标准。

结果

共分析了 29 名 COPD 患者(16 名女性;69±7 岁;BMI 27±5kg/m;FEV1 为预计值的 59±19%)。根据是否存在肌肉减少症将患者分组后,与无肌肉减少症的患者相比,有肌肉减少症的患者睡眠时间更短(81[75-85]%比 86[81-90]%;p=0.043),睡眠效率更低(77[69-83]%比 85[75-87]%;p=0.038),睡眠起始后醒来的时间更长(92[71-120]分钟比 58[47-83]分钟;p=0.0012),睡眠片段化更明显,表现为夜间睡眠片段数更多(46[41-49]个比 34[26-48]个;p=0.018),夜间清醒片段数更多(45[40-49]个比 34[26-48]个;p=0.018),以及夜间睡眠片段持续时间更短(9[8-10]分钟比 14[8-58]分钟;p=0.043)。两组间 PSQI 变量无统计学差异。然而,握力与 PSQI 第 2 项[R=-0.51,p=0.005]和第 5 项[R=-0.39,p=0.037]呈负相关。

结论

用握力测量的 COPD 患者肌肉减少症(sarcopenia)与客观测量的睡眠结果更差有关。虽然握力与主观睡眠之间存在弱到中度关联,但自我报告的睡眠质量较差情况并非如此。

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