Sleep disturbances and health-related quality of life in adults with steady-state bronchiectasis

Yonghua Gao, Weijie Guan, Gang Xu, Zhiya Lin, Yan Tang, Zhimin Lin, Huimin Li, Yang Gao, Qun Luo, Nanshan Zhong, Rongchang Chen, Yonghua Gao, Weijie Guan, Gang Xu, Zhiya Lin, Yan Tang, Zhimin Lin, Huimin Li, Yang Gao, Qun Luo, Nanshan Zhong, Rongchang Chen

Abstract

Background: Sleep disturbances are common in patients with chronic lung diseases, but little is known about the prevalence in patients with bronchiectasis. A cross sectional study was conducted to investigate the prevalence and determinants associated with sleep disturbances, and the correlation between sleep disturbances and quality of life (QoL) in adults with steady-state bronchiectasis.

Methods: One hundred and forty-four bronchiectasis patients and eighty healthy subjects were enrolled. Sleep disturbances, daytime sleepiness, and QoL were measured by utilizing the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and St. George Respiratory Questionnaire (SGRQ), respectively. Demographic, clinical indices, radiology, spirometry, bacteriology, anxiety and depression were also assessed.

Results: Adults with steady-state bronchiectasis had a higher prevalence of sleep disturbances (PSQI>5) (57% vs. 29%, P<0.001), but not daytime sleepiness (ESS≥10) (32% vs. 30%, P = 0.76), compared with healthy subjects. In the multivariate model, determinants associated with sleep disturbances in bronchiectasis patients included depression (OR, 10.09; 95% CI, 3.46-29.37; P<0.001), nocturnal cough (OR, 1.89; 95% CI, 1.13-3.18; P = 0.016), aging (OR, 1.04; 95% CI, 1.01-1.07; P = 0.009) and increased 24-hour sputum volume (OR, 2.01; 95% CI, 1.22-3.33; P = 0.006). Patients with sleep disturbances had more significantly impaired QoL affecting all domains than those without. Only 6.2% of patients reported using a sleep medication at least weekly.

Conclusions: In adults with steady-state bronchiectasis, sleep disturbances are more common than in healthy subjects and are related to poorer QoL. Determinants associated with sleep disturbances include depression, aging, nighttime cough and increased sputum volume. Assessment and intervention of sleep disturbances are warranted and may improve QoL.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Correlation between depression and PSQI…
Figure 1. Correlation between depression and PSQI total score in bronchiectasis patients.

References

    1. Pasteur MC, Bilton D, Hill AT (2010) British Thoracic Society guideline for non-CF bronchiectasis. Thorax 65 Suppl 1i1–58.
    1. Barker AF, Bardana EJ Jr (1988) Bronchiectasis: update of an orphan disease. Am Rev Respir Dis 137: 969–978.
    1. Martinez-Garcia MA, Perpina-Tordera M, Roman-Sanchez P, Soler-Cataluna JJ (2005) Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest 128: 739–745.
    1. Tsang KW, Bilton D (2009) Clinical challenges in managing bronchiectasis. Respirology 14: 637–650.
    1. De Soyza A, Brown JS, Loebinger MR (2013) Research priorities in bronchiectasis. Thorax 68: 695–696.
    1. Nunes DM, Mota RM, de Pontes Neto OL, Pereira ED, de Bruin VM, et al. (2009) Impaired sleep reduces quality of life in chronic obstructive pulmonary disease. Lung 187: 159–163.
    1. Jankelowitz L, Reid KJ, Wolfe L, Cullina J, Zee PC, et al. (2005) Cystic fibrosis patients have poor sleep quality despite normal sleep latency and efficiency. Chest 127: 1593–1599.
    1. Krishnan V, McCormack MC, Mathai SC, Agarwal S, Richardson B, et al. (2008) Sleep quality and health-related quality of life in idiopathic pulmonary fibrosis. Chest 134: 693–698.
    1. Erdem E, Ersu R, Karadag B, Karakoc F, Gokdemir Y, et al. (2011) Effect of night symptoms and disease severity on subjective sleep quality in children with non-cystic-fibrosis bronchiectasis. Pediatr Pulmonol 46: 919–926.
    1. Bouka A, Tiede H, Liebich L, Dumitrascu R, Hecker C, et al. (2012) Quality of life in clinically stable adult cystic fibrosis out-patients: associations with daytime sleepiness and sleep quality. Respir Med 106: 1244–1249.
    1. Scharf SM, Maimon N, Simon-Tuval T, Bernhard-Scharf BJ, Reuveni H, et al. (2011) Sleep quality predicts quality of life in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 6: 1–12.
    1. Havlikova E, van Dijk JP, Nagyova I, Rosenberger J, Middel B, et al. (2011) The impact of sleep and mood disorders on quality of life in Parkinson’s disease patients. J Neurol 258: 2222–2229.
    1. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28: 193–213.
    1. Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, et al. (2005) Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Qual Life Res 14: 1943–1952.
    1. Chen NH, Johns MW, Li HY, Chu CC, Liang SC, et al. (2002) Validation of a Chinese version of the Epworth sleepiness scale. Qual Life Res 11: 817–821.
    1. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14: 540–545.
    1. Fokkens W, Lund V, Mullol J (2007) EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology 45: 97–101.
    1. Hsu JY, Stone RA, Logan-Sinclair RB, Worsdell M, Busst CM, et al. (1994) Coughing frequency in patients with persistent cough: assessment using a 24 hour ambulatory recorder. Eur Respir J 7: 1246–1253.
    1. Mahler DA, Wells CK (1988) Evaluation of clinical methods for rating dyspnea. Chest 93: 580–586.
    1. Pasteur MC, Helliwell SM, Houghton SJ, Webb SC, Foweraker JE, et al. (2000) An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med 162: 1277–1284.
    1. Leung CM, Wing YK, Kwong PK, Lo A, Shum K (1999) Validation of the Chinese-Cantonese version of the hospital anxiety and depression scale and comparison with the Hamilton Rating Scale of Depression. Acta Psychiatr Scand 100: 456–461.
    1. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67: 361–370.
    1. Chan SL, Chan-Yeung MM, Ooi GC, Lam CL, Cheung TF, et al. (2002) Validation of the Hong Kong Chinese version of the St. George Respiratory Questionnaire in patients with bronchiectasis. Chest 122: 2030–2037.
    1. Wilson CB, Jones PW, O’Leary CJ, Cole PJ, Wilson R (1997) Validation of the St. George’s Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med 156: 536–541.
    1. Maggi S, Langlois JA, Minicuci N, Grigoletto F, Pavan M, et al. (1998) Sleep complaints in community-dwelling older persons: prevalence, associated factors, and reported causes. J Am Geriatr Soc 46: 161–168.
    1. Lindberg E, Janson C, Gislason T, Bjornsson E, Hetta J, et al. (1997) Sleep disturbances in a young adult population: can gender differences be explained by differences in psychological status? Sleep 20: 381–387.
    1. Batal O, Khatib OF, Bair N, Aboussouan LS, Minai OA (2011) Sleep quality, depression, and quality of life in patients with pulmonary hypertension. Lung 189: 141–149.
    1. Costa DD, Bernatsky S, Dritsa M, Clarke AE, Dasgupta K, et al. (2005) Determinants of sleep quality in women with systemic lupus erythematosus. Arthritis Rheum 53: 272–278.
    1. Ford DE, Kamerow DB (1989) Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA 262: 1479–1484.
    1. King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW (2006) Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respir Med 100: 2183–2189.
    1. Klink ME, Dodge R, Quan SF (1994) The relation of sleep complaints to respiratory symptoms in a general population. Chest 105: 151–154.
    1. Chan KK, Ing AJ, Laks L, Cossa G, Rogers P, et al. (2010) Chronic cough in patients with sleep-disordered breathing. Eur Respir J 35: 368–372.
    1. Milross MA, Piper AJ, Norman M, Dobbin CJ, Grunstein RR, et al. (2002) Subjective sleep quality in cystic fibrosis. Sleep Med 3: 205–212.
    1. Olveira C, Olveira G, Gaspar I, Dorado A, Cruz I, et al. (2013) Depression and anxiety symptoms in bronchiectasis: associations with health-related quality of life. Qual Life Res 22: 597–605.
    1. O’Leary CJ, Wilson CB, Hansell DM, Cole PJ, Wilson R, et al. (2002) Relationship between psychological well-being and lung health status in patients with bronchiectasis. Respir Med 96: 686–692.

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