TY - JOUR
T1 - Impaired Sleep Quality in COPD Is Associated With Exacerbations
T2 - The CanCOLD Cohort Study
AU - Canadian Respiratory Research Network
AU - CanCOLD Collaborative Research group
AU - Shorofsky, Matthew
AU - Bourbeau, Jean
AU - Kimoff, John
AU - Jen, Rachel
AU - Malhotra, Atul
AU - Ayas, Najib
AU - Tan, Wan C.
AU - Aaron, Shawn D.
AU - Sin, Don D.
AU - Road, Jeremy
AU - Chapman, Kenneth R.
AU - O'Donnell, Denis E.
AU - Maltais, François
AU - Hernandez, Paul
AU - Walker, Brandie L.
AU - Marciniuk, Darcy
AU - Kaminska, Marta
AU - FitzGerald, J. Mark
AU - Marciniuk, D. D.
AU - O'Donnell, D. E.
AU - Cowie, Robert
AU - Maltais, F.
AU - Samet, Jonathon
AU - Puhan, Milo
AU - Hamid, Qutayba
AU - Hogg, James C.
AU - Baglole, Carole
AU - Jabet, Carole
AU - Mancino, Palmina
AU - Fortier, Yvan
AU - Tam, Sheena
AU - Comeau, Joe
AU - Png, Adrian
AU - Coxson, Harvey
AU - Kirby, Miranda
AU - Leipsic, Jonathon
AU - Hague, Cameron
AU - Sadatsafavi, Mohsen
AU - Gershon, Andrea
AU - Li, Pei Zhi
AU - Duquette, Jean Francois
AU - Benedetti, Andrea
AU - Jensen, Denis
AU - O'Donnell, Denis
AU - Lo, Christine
AU - Cheng, Sarah
AU - Fung, Cindy
AU - Ferguson, Nancy
AU - Haynes, Nancy
AU - Chuang, Junior
N1 - Publisher Copyright:
© 2019
PY - 2019/11
Y1 - 2019/11
N2 - Background: COPD increases susceptibility to sleep disturbances, which may in turn predispose to increased respiratory symptoms. The objective of this study was to evaluate, in a population-based sample, the relationship between subjective sleep quality and risk of COPD exacerbations. Methods: Data were obtained from the Canadian Cohort Obstructive Lung Disease (CanCOLD) study. Participants with COPD who had completed 18 months of follow-up were included. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and a three-factor analysis. Symptom-based (dyspnea or sputum change ≥ 48 h) and event-based (symptoms plus medication or unscheduled health services use) exacerbations were assessed. Association of PSQI with exacerbation rate was assessed by using negative binomial regression. Exacerbation-free survival was also assessed. Results: A total of 480 participants with COPD were studied, including 185 with one or more exacerbations during follow-up and 203 with poor baseline sleep quality (PSQI score > 5). Participants with subsequent symptom-based exacerbations had higher median baseline PSQI scores than those without (6.0 [interquartile range, 3.0-8.0] vs 5.0 [interquartile range, 2.0-7.0]; P = .01), and they were more likely to have baseline PSQI scores > 5 (50.3% vs 37.3%; P = .01). Higher PSQI scores were associated with increased symptom-based exacerbation risk (adjusted rate ratio, 1.09; 95% CI, 1.01-1.18; P = .02) and event-based exacerbation risk (adjusted rate ratio, 1.10; 95% CI, 1.00-1.21; P = .048). The association occurred mainly in those with undiagnosed COPD. Strongest associations were with Factor 3 (sleep disturbances and daytime dysfunction). Time to symptom-based exacerbation was shorter in participants with poor sleep quality (adjusted hazard ratio, 1.49; 95% CI, 1.09-2.03). Conclusions: Higher baseline PSQI scores were associated with increased risk of COPD exacerbation over 18 months’ prospective follow-up.
AB - Background: COPD increases susceptibility to sleep disturbances, which may in turn predispose to increased respiratory symptoms. The objective of this study was to evaluate, in a population-based sample, the relationship between subjective sleep quality and risk of COPD exacerbations. Methods: Data were obtained from the Canadian Cohort Obstructive Lung Disease (CanCOLD) study. Participants with COPD who had completed 18 months of follow-up were included. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and a three-factor analysis. Symptom-based (dyspnea or sputum change ≥ 48 h) and event-based (symptoms plus medication or unscheduled health services use) exacerbations were assessed. Association of PSQI with exacerbation rate was assessed by using negative binomial regression. Exacerbation-free survival was also assessed. Results: A total of 480 participants with COPD were studied, including 185 with one or more exacerbations during follow-up and 203 with poor baseline sleep quality (PSQI score > 5). Participants with subsequent symptom-based exacerbations had higher median baseline PSQI scores than those without (6.0 [interquartile range, 3.0-8.0] vs 5.0 [interquartile range, 2.0-7.0]; P = .01), and they were more likely to have baseline PSQI scores > 5 (50.3% vs 37.3%; P = .01). Higher PSQI scores were associated with increased symptom-based exacerbation risk (adjusted rate ratio, 1.09; 95% CI, 1.01-1.18; P = .02) and event-based exacerbation risk (adjusted rate ratio, 1.10; 95% CI, 1.00-1.21; P = .048). The association occurred mainly in those with undiagnosed COPD. Strongest associations were with Factor 3 (sleep disturbances and daytime dysfunction). Time to symptom-based exacerbation was shorter in participants with poor sleep quality (adjusted hazard ratio, 1.49; 95% CI, 1.09-2.03). Conclusions: Higher baseline PSQI scores were associated with increased risk of COPD exacerbation over 18 months’ prospective follow-up.
KW - COPD
KW - acute exacerbation of chronic bronchitis
KW - sleep medicine
UR - https://www.scopus.com/pages/publications/85071726261
U2 - 10.1016/j.chest.2019.04.132
DO - 10.1016/j.chest.2019.04.132
M3 - Article
C2 - 31150638
AN - SCOPUS:85071726261
SN - 0012-3692
VL - 156
SP - 852
EP - 863
JO - Chest
JF - Chest
IS - 5
ER -
SDG 3 Good Health and Well-being