Pulmonary rehabilitation and sleep quality: a before and after controlled study of patients with chronic obstructive pulmonary disease

TY - JOUR

T1 - Pulmonary rehabilitation and sleep quality

T2 - a before and after controlled study of patients with chronic obstructive pulmonary disease

AU - McDonnell, Lucy M.

AU - Hogg, Lauren

AU - McDonnell, Lynn

AU - White, Patrick

PY - 2014

Y1 - 2014

N2 - BACKGROUND: Poor sleep quality is common in chronic obstructive pulmonary disease (COPD). It is associated with poor quality of life. Pulmonary rehabilitation (PR) improves quality of life, exercise capacity, and anxiety and depression. Its effect on sleep quality is uncertain.AIM: To determine whether PR improves sleep quality in COPD.METHODS: A prospective controlled 'before and after' study of sleep quality in COPD patients attending a community PR programme was conducted. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Lung function, disease-specific quality of life (COPD assessment test-CAT), exercise capacity (incremental shuttle walk test-ISWT), and anxiety and depression (Hospital Anxiety and Depression Scale-HADS) were measured. Change in sleep quality was compared with a COPD control group.RESULTS: Twenty-eight participants completed PR. The control group comprised 24 patients. Prevalence of poor sleep quality (PSQI >= 5) was 78%. There were no differences between observation and control groups in sleep quality, age or severity. Quality of life was strongly correlated with quality of sleep (r = 0.64, P <0.001). PR improved the quality of life (CAT change 3.0; 95% CI, 0.7-5.3), exercise capacity (ISWT change (metres) 81.0; 15.3-146.6), anxiety (HADS score >= 8: change 2.33; 0.45-4.22), and depression (HADS score >= 8: change 2.90; 1.92-3.88). PR did not improve sleep quality (PSQI mean change 0.79; -0.35 to 1.93).CONCLUSIONS: PR did not improve sleep quality in COPD despite improving quality of life, exercise capacity, anxiety and depression. New strategies, independent of PR, are required to improve sleep quality in COPD.

AB - BACKGROUND: Poor sleep quality is common in chronic obstructive pulmonary disease (COPD). It is associated with poor quality of life. Pulmonary rehabilitation (PR) improves quality of life, exercise capacity, and anxiety and depression. Its effect on sleep quality is uncertain.AIM: To determine whether PR improves sleep quality in COPD.METHODS: A prospective controlled 'before and after' study of sleep quality in COPD patients attending a community PR programme was conducted. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Lung function, disease-specific quality of life (COPD assessment test-CAT), exercise capacity (incremental shuttle walk test-ISWT), and anxiety and depression (Hospital Anxiety and Depression Scale-HADS) were measured. Change in sleep quality was compared with a COPD control group.RESULTS: Twenty-eight participants completed PR. The control group comprised 24 patients. Prevalence of poor sleep quality (PSQI >= 5) was 78%. There were no differences between observation and control groups in sleep quality, age or severity. Quality of life was strongly correlated with quality of sleep (r = 0.64, P <0.001). PR improved the quality of life (CAT change 3.0; 95% CI, 0.7-5.3), exercise capacity (ISWT change (metres) 81.0; 15.3-146.6), anxiety (HADS score >= 8: change 2.33; 0.45-4.22), and depression (HADS score >= 8: change 2.90; 1.92-3.88). PR did not improve sleep quality (PSQI mean change 0.79; -0.35 to 1.93).CONCLUSIONS: PR did not improve sleep quality in COPD despite improving quality of life, exercise capacity, anxiety and depression. New strategies, independent of PR, are required to improve sleep quality in COPD.

KW - SHUTTLE WALKING TEST

KW - COPD PATIENTS

KW - NOCTURNAL HYPOXEMIA

KW - SUBJECTIVE SLEEP

KW - LUNG-DISEASE

KW - OF-LIFE

KW - DESATURATION

KW - PREVALENCE

KW - DEPRESSION

KW - INSOMNIA

U2 - 10.1038/npjpcrm.2014.28

DO - 10.1038/npjpcrm.2014.28

M3 - Article

SN - 2055-1010

VL - 24

JO - npj Primary Care Respiratory Medicine

JF - npj Primary Care Respiratory Medicine

M1 - 14028

ER -