RATIONALE: Sleep disturbance frequently affects patients with chronic obstructive pulmonary disease (COPD), and is associated with reduced quality of life and poorer outcomes. Data indicate that smokers with preserved pulmonary function have clinical symptoms similar to those meeting spirometric criteria for COPD, but little is known about the driving factors for sleep disturbance in this population of emerging interest. OBJECTIVES: To compare the magnitude and correlates of sleep disturbance between smokers with preserved pulmonary function and those with airflow obstruction. METHODS: Using cross-sectional data from the COPD Outcomes-Based Network for Clinical Effectiveness and Research Translation multicenter registry, we identified participants clinically identified as having COPD with a smoking history of at least 20 pack-years and either preserved pulmonary function or airflow obstruction. We quantified sleep disturbance by T-score measured in the sleep disturbance domain of the Patient-Reported Outcomes Information System questionnaire, and defined a minimum important difference as a T-score difference of two points. We performed univariate and multivariable linear regression to evaluate correlates within each group. RESULTS: We identified 100 smokers with preserved pulmonary function and 476 with airflow obstruction. The sleep disturbance T-score was 4.1 points greater among individuals with preserved pulmonary function (95% confidence interval [CI], 2.0-6.3). In adjusted analyses, depression symptom T-score was associated with sleep disturbance in both groups (airflow obstruction: β, 0.61 points; 95% CI, 0.27-0.94; preserved pulmonary function: β, 0.25 points; 95% CI, 0.12-0.38). Of note, lower percent predicted FEV1 was associated with greater sleep disturbance among those with preserved pulmonary function (β, -0.19 points; 95% CI, -0.31 to -0.07), whereas higher FEV1 was associated with greater sleep disturbance among individuals with airflow obstruction (β, 0.06 points; 95% CI, 0.01-0.10). CONCLUSIONS: Among smokers with clinically identified COPD, the severity of sleep disturbance is greater among those with preserved pulmonary function compared with those with airflow obstruction. Nonrespiratory symptoms, such as depression, were associated with sleep disturbance in both groups, whereas the relationship of sleep disturbance with FEV1 differed.
RATIONALE: Sleep disturbance frequently affects patients with chronic obstructive pulmonary disease (COPD), and is associated with reduced quality of life and poorer outcomes. Data indicate that smokers with preserved pulmonary function have clinical symptoms similar to those meeting spirometric criteria for COPD, but little is known about the driving factors for sleep disturbance in this population of emerging interest. OBJECTIVES: To compare the magnitude and correlates of sleep disturbance between smokers with preserved pulmonary function and those with airflow obstruction. METHODS: Using cross-sectional data from the COPD Outcomes-Based Network for Clinical Effectiveness and Research Translation multicenter registry, we identified participants clinically identified as having COPD with a smoking history of at least 20 pack-years and either preserved pulmonary function or airflow obstruction. We quantified sleep disturbance by T-score measured in the sleep disturbance domain of the Patient-Reported Outcomes Information System questionnaire, and defined a minimum important difference as a T-score difference of two points. We performed univariate and multivariable linear regression to evaluate correlates within each group. RESULTS: We identified 100 smokers with preserved pulmonary function and 476 with airflow obstruction. The sleep disturbance T-score was 4.1 points greater among individuals with preserved pulmonary function (95% confidence interval [CI], 2.0-6.3). In adjusted analyses, depression symptom T-score was associated with sleep disturbance in both groups (airflow obstruction: β, 0.61 points; 95% CI, 0.27-0.94; preserved pulmonary function: β, 0.25 points; 95% CI, 0.12-0.38). Of note, lower percent predicted FEV1 was associated with greater sleep disturbance among those with preserved pulmonary function (β, -0.19 points; 95% CI, -0.31 to -0.07), whereas higher FEV1 was associated with greater sleep disturbance among individuals with airflow obstruction (β, 0.06 points; 95% CI, 0.01-0.10). CONCLUSIONS: Among smokers with clinically identified COPD, the severity of sleep disturbance is greater among those with preserved pulmonary function compared with those with airflow obstruction. Nonrespiratory symptoms, such as depression, were associated with sleep disturbance in both groups, whereas the relationship of sleep disturbance with FEV1 differed.
Authors: Alcides Rocha; Flavio F Arbex; Priscilla A Sperandio; Aline Souza; Ligia Biazzim; Frederico Mancuso; Danilo C Berton; Bruno Hochhegger; Maria Clara N Alencar; Luiz E Nery; Denis E O'Donnell; J Alberto Neder Journal: Am J Respir Crit Care Med Date: 2017-11-15 Impact factor: 21.405
Authors: Frans H Rutten; Maarten-Jan M Cramer; Diederick E Grobbee; Alfred P E Sachs; Johannes H Kirkels; Jan-Willem J Lammers; Arno W Hoes Journal: Eur Heart J Date: 2005-04-28 Impact factor: 29.983
Authors: Daniel J Buysse; Lan Yu; Douglas E Moul; Anne Germain; Angela Stover; Nathan E Dodds; Kelly L Johnston; Melissa A Shablesky-Cade; Paul A Pilkonis Journal: Sleep Date: 2010-06 Impact factor: 5.849
Authors: Susan E Yount; Seung W Choi; David Victorson; Bernice Ruo; David Cella; Susan Anton; Alan Hamilton Journal: Value Health Date: 2011 Mar-Apr Impact factor: 5.725
Authors: Marvin A Konstam; Michael Kiernan; Arthur Chandler; Ravi Dhingra; Freny Vaghaiwalla Mody; Howard Eisen; W Herbert Haught; Lynne Wagoner; Divya Gupta; Richard Patten; Paul Gordon; Kenneth Korr; Russell Fileccia; Susan J Pressler; Douglas Gregory; Patricia Wedge; Douglas Dowling; Matthew Romeling; Jeremy M Konstam; Joseph M Massaro; James E Udelson Journal: J Am Coll Cardiol Date: 2017-03-21 Impact factor: 24.094
Authors: Lucas M Donovan; Carol A Malte; Laura J Spece; Matthew F Griffith; Laura C Feemster; Ruth A Engelberg; David H Au; Eric J Hawkins Journal: Ann Am Thorac Soc Date: 2019-01