Factors associated with sleep disturbance in patients with chronic obstructive pulmonary disease.

Poor sleep quality in patients with chronic obstructive pulmonary disease (COPD) has been associated with poor health outcomes. However, there is a lack of research on factors associated with sleep disturbance in patients with COPD. We investigated patterns of sleep disturbance and factors associated with sleep impairment in patients with COPD. This was a prospective, multicenter cross-sectional study enrolling a sample of 245 COPD subjects. All patients completed the patient-reported measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. The St. George's Respiratory Questionnaire (SGRQ), the 36-item Short-Form health survey (SF-36), Hospital Anxiety and Depression Scale (HADS), and the COPD Self-Efficacy Scale (CSES) were utilized to assess health-related quality of life (HRQL), anxiety/depression and self-efficacy, respectively. About 35.1% of the patients reported that they had a bad night's sleep. Univariate analysis showed that the CASIS total score was significantly correlated with the modified Medical Research Council dyspnea scale, SGRQ total score, SF-36 PCS, SF-36 MCS, HADS-A, HADS-D and CSES (all P < 0.05). In a multivariate analysis, SGRQ total (r = 0.19, P = 0.006), SF-36 PCS (r = 0.14, P = 0.037), HADS-D (r = 0.24, P ≤ 0.001), and CSES(r = -0.12, P = 0.010) were independently associated with the CASIS score. In this study, 35% of clinically stable patients with COPD reported poor sleep quality. Depression, poorer HRQL and self-efficacy were significantly associated with sleep disturbance in patients with COPD.

Lee SH ，Lee H ，Kim YS ，Kim KU ，Park HK ，Lee MK ... -  《-》

Sleep disturbance in patients with mild-moderate chronic obstructive pulmonary disease.

Although sleep problems have an important impact on daily life and health outcome measures in patients with chronic obstructive pulmonary disease (COPD), patterns of sleep disturbance in patients with mild-moderate COPD remain unknown. The aim of this study was to investigate patterns of sleep disturbance and factors associated with sleep impairment in patients with mild-moderate COPD. This prospective cross-sectional study enrolled 148 male patients with COPD. At enrolment, all patients completed a disease-specific sleep measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. Health-related quality of life (HRQL) was measured using the St. George's Respiratory Questionnaire (SGRQ) and the 36-item Short-Form health survey (SF-36). Anxiety and depression status were assessed using the Hospital Anxiety and Depression Scale (HADS). Self-efficacy was measured by the COPD Self-Efficacy Scale (CSES). The mean age of the subjects was 67 years [standard deviation (SD) = 8.11]. The proportion of patients who indicated that they had a bad night's sleep was 33.1%. Univariated analysis showed that CASIS score was significantly correlated with the modified Medical Research Council (mMRC) dyspnea scale, SGRQ, SF-36 Physical Component Summary, SF-36 Mental Component Summary, HADS-anxiety, HADS-depression and CSES scores (all P < 0.05). In a multivariate analysis, SGRQ and CSES were independently associated with CASIS score. Poorer HRQL and lower self-efficacy are significantly associated with sleep disturbance and perhaps may be improved by better sleep quality. Future research is required to enhance sleep quality in patients with mild-moderate COPD.

Lee SH ，Kim KU ，Lee H ，Park HK ，Kim YS ，Lee MK ... -  《-》

Social support is a strong determinant of life satisfaction among older adults with chronic obstructive pulmonary disease.

Older adults with chronic obstructive pulmonary disease (COPD) are frequently compromised in terms of social life and functional capacity, triggering reduced in life satisfaction (LS). We investigated the level of LS among elderly patients with COPD and factors associated with LS. This was a prospective cross-sectional survey enroling a sample of 160 COPD subjects aged 65 y or older. At enrolment, all patients completed measures of LS (the Satisfaction with Life Scale; SWLS) and social support (Personal Resource Questionnaire; PRQ). The health-related quality of life (HRQL) was measured using St. George's Respiratory Questionnaire (SGRQ) and 36-item Short-Form Health Survey (SF-36). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). About 30.6% of the patients reported that they were satisfied or highly satisfied with their lives. In univariate analysis, post-bronchodilator FEV1, percentage predicted was significantly associated with SWLS score (r = 0.205, P = .009). Age (r = 0.207), diabetes (r = 0.209), osteoporosis (r = -0.190), PRQ (r = 0.388), SGRQ total (r = -0.291), SF-36 PCS (r = 0.233), SF-36 MCS (r = 0.274), HADS-A (r = -0.291) and HADS-D (r = -0.352) were also associated with SWLS score (all P < .05). Multivariate analysis revealed that FEV1 (r = 0.223, P = .04) and PRQ (r = .244, P = .002) were independently associated with SWLS score. Less than one-third of older adults with COPD reported that they were satisfied with their lives. Better lung function and greater social support were independently associated with high LS.

Lee SH ，Lee H ，Kim YS ，Park HK ，Lee MK ，Kim KU ... -  《-》

Factors associated with low-level physical activity in elderly patients with chronic obstructive pulmonary disease.

Lee SH ，Kim KU ，Lee H ，Kim YS ，Lee MK ，Park HK ... -  《-》

Association of chronic nasal symptoms with dyspnoea and quality-of-life impairment in chronic obstructive pulmonary disease.

Previous studies suggested that chronic nasal symptoms (CNS) are frequent in chronic obstructive pulmonary disease (COPD) subjects, but their contribution to dyspnoea and quality-of-life (QoL) impairment is not clearly established. Data from the French COPD cohort 'Initiatives bronchopneumopathie chronique obstructive' were analyzed to assess the frequency of CNS (rhinorrhea, obstruction, anosmia) in COPD patients and analyze their impact and associated risk factors. Univariate and multivariate analyses were performed to assess the relationship between CNS with sociodemographic and anthropometric characteristics, risk factors, respiratory symptoms, spirometry, QoL (Saint George's respiratory questionnaire (SGRQ)), dyspnoea (modified Medical Research Council (mMRC) scale), mood disorders (Hospital Anxiety and Depression Scale (HADS)), number of exacerbations and comorbid conditions. CNS were reported by 115 of 274 COPD subjects (42%). Among them, rhinorrhea and nasal obstruction were reported by 62% and 43%, respectively. In multivariate analysis, COPD patients with CNS had higher SGRQ total scores, corresponding to worse QoL (P = 0.01), while no independent association was found with exacerbations, lung function and HADS. Among SGRQ domains, an independent association was found with the activity score (P = 0.007). When SGRQ score was forced out of the model to avoid redundancy, mMRC score was independently associated with CNS (P = 0.01). Among risk factors, cumulative smoking, hay fever and atopic dermatitis but not occupational exposures were independently associated with CNS. In this group of COPD subjects, CNS were frequently observed and associated with dyspnoea and poorer QoL. CNS should be systematically assessed and could be a potential target in the management of COPD.

Caillaud D ，Chanez P ，Escamilla R ，Burgel PR ，Court-Fortune I ，Nesme-Meyer P ，Deslee G ，Perez T ，Pinet C ，Roche N ，Initiatives BPCO Scientific Committee and Investigators ... -  《-》