Sleep quality predicts quality of life in chronic obstructive pulmonary disease

Steven M Scharf, Nimrod Maimon, Tzahit Simon-Tuval, Barbara J Bernhard-Scharf, Haim Reuveni, Ariel Tarasiuk, Steven M Scharf, Nimrod Maimon, Tzahit Simon-Tuval, Barbara J Bernhard-Scharf, Haim Reuveni, Ariel Tarasiuk

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) patients may suffer from poor sleep and health-related quality of life. We hypothesized that disturbed sleep in COPD is correlated with quality of life.

Methods: In 180 patients with COPD (forced expired volume in 1 second [FEV(1)] 47.6 ± 15.2% predicted, 77.8% male, aged 65.9 ± 11.7 years), we administered general (Health Utilities Index 3) and disease-specific (St George's Respiratory) questionnaires and an index of disturbed sleep (Pittsburgh Sleep Quality Index).

Results: Overall scores indicated poor general (Health Utilities Index 3: 0.52 ± 0.38), disease- specific (St George's: 57.0 ± 21.3) quality of life and poor sleep quality (Pittsburgh 11.0 ± 5.4). Sleep time correlated with the number of respiratory and anxiety symptoms reported at night. Seventy-seven percent of the patients had Pittsburg scores >5, and the median Pittsburgh score was 12. On multivariate regression, the Pittsburgh Sleep Quality Index was an independent predictor of both the Health Utilities Index 3 and the St George's scores, accounting for 3% and 5%, respectively, of the scores. Only approximately 25% of the patients demonstrated excessive sleepiness (Epworth Sleepiness Scale >9).

Conclusions: Most patients with COPD suffer disturbed sleep. Sleep quality was correlated with general and disease-specific quality of life. Only a minority of COPD patients complain of being sleepy.

Keywords: COPD; Health Utilities Index; Pittsburgh Sleep Quality Index; St George’s Respiratory Questionnaire; quality of life; sleep quality.

Figures

Figure 1
Figure 1
Sleep symptom questionnaire. Note: On average, how many days/nights during the last month have you had the following WHILE ASLEEP OR TYRING TO SLEEP? (circle your best estimate).

References

    1. Hajiro T, Nishimura K, Tsukino M, Ikeda A, Oga T, Izumi T. A comparison of the level of dyspnea vs disease severity in indicating the health-related quality of life of patients with COPD. Chest. 1999;116:1632–1637.
    1. Schlecht NF, Schwartzman K, Bourbeau J. Dyspnea as clinical indicator in patients with chronic obstructive pulmonary disease. Chron Resp Dis. 2005;2:183–191.
    1. Mahler DA, Faryniarz K, Tomlinson D, et al. Impact of dyspnea and physiologic function on general health status in patients with chronic obstructive pulmonary disease. Chest. 1992;102:395–401.
    1. Jones PW. Health status measurement in chronic obstructive pulmonary disease. Thorax. 2001;6:880–887.
    1. Benzo R, Farrell MH, Chang CCH, et al. Integrating health status and survival data. The palliative effect of lung volume reduction surgery. Am J Resp Crit Care Med. 2009;180:239–246.
    1. Krachman S, Minai MA, Scharf SM. Sleep abnormalities and treatment in emphysema. Proc Am Thorac Soc. 2008;5:536–542.
    1. Collop N. Sleep and sleep disorders in chronic obstructive pulmonary disease. Respiration. 2009 Nov 12; [Epub ahead of print]
    1. Wynne JW, Block AJ, Hemenway J, Hunt LA, Flick MR. Disordered breathing and oxygen desaturation during sleep in patients with chronic obstructive lung disease. Am J Med. 1979;66:573–579.
    1. Calverley PM, Brezinova V, Douglas NJ, Catterall JR, Flenley DC. The effect of oxygenation on sleep quality in chronic bronchitis and emphysema. Am Rev Respir Dis. 1982;126:206–210.
    1. Cormick W, Olson LG, Hensley MJ, Saunders NA. Nocturnal hypoxaemia and quality of sleep in patients with chronic obstructive lung disease. Thorax. 1986;41:846–854.
    1. Nunes DM, Mota RMS, de Pontes Neto OL, Pereira ED, de Bruin VM, de Bruin PF. Impaired sleep reduces quality of life in chronic obstructive pulmonary disease. Lung. 2009;187:159–163.
    1. Hynninen MJ, Pallesen S, Nordhus IH. Factors affecting health status in COPD patients with comorbid anxiety or depression. Int J Chron Obstruct Pulmon Dis. 2007;2:323–328.
    1. American Thoracic Society. Standardization of spirometry 1994 update. Am J Resp Crit Care Med. 1995;152:1107–1136.
    1. Global Initiative for Chronic Obstructive Lung Disease. MCR Vision, Inc; 2006.
    1. Chien WT, Norman I. The validity and reliability of a Chinese version of the family burden interview schedule. Nursing Res. 2004;53:314–322.
    1. Feeny D, Furlong W, Saigal S, Sun J. Comparing directly measured standard gamble scores to HUI2 and HUI3 utility scores: group- and individual-level comparisons. Soc Sci Med. 2004;58:799–809.
    1. Furlong WJ, Feeny DH, Torrance GW, Barr RD. The Health Utilities Index (HUI) for assessing health related quality of life in clinical studies. Ann Med. 2001;33:375–384.
    1. Welch K, Scharf SM. Construct validity for the Health Utilities Index in a sleep center. Sleep Breath. 2007;11:295–303.
    1. Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation: the St George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992;145:1321–1327.
    1. Meguro M, Barley EA, Spencer S, Jones PW. Development and validation of an improved, COPD-specific version of the Saint George’s Respiratory Questionnaire. Chest. 2007;132:456–463.
    1. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:192–213.
    1. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–545.
    1. Mastronarde JG, Wise RA, Shade DM, Olopade CO, Scharf SM. Sleep quality in asthma: results of a large prospective clinical trial. J Asthma. 2008;45:183–189.
    1. Lin PJ, Shaya FT, Scharf SM. Economic implications of comorbid conditions among Medicaid beneficiaries with COPD. Respir Med. 2009 Dec 1; [Epub ahead of print]
    1. Vilkman S, Keistinen T, Tuuponen T, Kivelä SL. Survival and cause of death among elderly chronic obstructive pulmonary disease patients after first admission to hospital. Respiration. 1997;64:281–284.
    1. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–619.
    1. O’Connell RL, Lim LL-Y. Utility of the Charlson comorbidiy index computed from routinely collected hospital discharge diagnosis codes. Methods Inf Med. 2000;39:7–11.
    1. Grootendorst P, Feeny D, Furlong W. Health Utilities Index mark 3: evidence of construct validity for stroke and arthritis in a population health survey. Med Care. 2000;38:290–299.
    1. Luo N, Johnson JA, Shaw JW, Feeny D, Coons SJ. Self-reported health status of the general adult US population as assessed by the EQ-5D and Health Utilities Index. Med Care. 2005;43:1078–1086.
    1. Shaya FT, Samant ND, Pradel FG, Mullins CD, Scharf SM, Britt EJ. Health-related quality of life as a potential predictor in chronic obstructive lung disease patients. Expert Rev Pharmacoecon Outcomes Res. 2007;7:129–135.
    1. Sawka AM, Thabane L, Papaioannou A, Gafni A, Ioannidis G, Papadimitropoulos EA. Health-related quality of life measurements in elderly Canadians with osteoporosis compared to other chronic medical conditions: a population-based study from the Canadian Multicentre Osteoporosis Study (CaMos) Osteoporos Int. 2005;16:1836–1840.
    1. Szecket N, Medin G, Furlong WJ, Feeny DH, Barr RD, Depauw S. Preliminary translation and cultural adaptation of Health Utilities Index questionnaires for application in Argentina. Int J Cancer Suppl. 1999;12:119–124.
    1. Weaver TE, Laizner AM, Evans LK, Maislin G, Chugh DK, Lyon K. An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep. 1997;20:835–843.
    1. Fong SY, Ho CK, Wing YK. Comparing MSLT and ESS in the measurement of excessive daytime sleepiness in obstructive sleep apnoea syndrome. J Psychosomatic Res. 2005;58:55–60.
    1. Veale D, Cooper BG, Griffiths CJ, Corris PA, Gibson GJ. The effect of controlled-release salbutamol on sleep and nocturnal oxygenation in patients with asthma and chronic obstructive pulmonary disease. Respir Med. 1994;88:121–124.
    1. Mulloy E, McNicholas WT. Theophylline improves gas exchange during rest, exercise and sleep in severe chronic obstructive pulmonary disease. Am Rev Respir Dis. 1993;148:1030–1036.
    1. Martin RJ, Pak J. Overnight theophylline concentrations and effects on sleep and lung function in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1992;145:540–544.
    1. Martin RJ, Bucher Bartelson B, Smith P, Hudgel DW, Lewis D, Pohl G. Effect of ipratropium bromide treatment on oxygen saturation and sleep quality in COPD. Chest. 1999;115:1338–1345.
    1. McNicholas WT, Calverley PM, Lee A, Edwards JC. Long-acting inhaled anticholinergic therapy improves sleeping oxygen saturation in COPD. Eur Respir J. 2004;23:825–831.
    1. Nunnally J, Bernstein I. Psychometric Theory. New York: McGraw-Hill; 1994. Special problems in classical test theory; pp. 376–386.
    1. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–333.
    1. Nunnally JC. Psychometric Theory. New York, NY: McGraw-Hill; 1978.
    1. Von Neumann J, Morgenstern O. Theory of games and economic behaviour. Princeton, NJ: Princeton University Press; 1944.
    1. Le GC, Buron C, Costet N, et al. Development of a preference-weighted health status classification system in France: the Health Utilities Index 3. Health Care Manage Sci. 2002;5:41–51.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj