Chronisch-obstruktive Lungenerkrankung: Verbesserung von Schlaf und Tagesmüdigkeit durch pneumologische Rehabilitation

2020 ◽  
Vol 8 (4) ◽  
pp. 200-201
Author(s):  
Guzel Gafina ◽  
Marc Spielmanns
Keyword(s):  
Sleep Quality ◽  
Pulmonary Rehabilitation ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Poor Sleep ◽  
Daytime Somnolence ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Copd Patients ◽  
Pulmonary Rehabilitation Program

Background: Dyspnea, fatigue, and decline in sleep quality are symptoms of chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation programs have been shown to ameliorate dyspnea and fatigue. However, only a few studies have investigated the effects of pulmonary rehabilitation on the sleep quality of COPD patients. In this study, we analyzed the benefits of a pulmonary rehabilitation program to sleep quality and daytime somnolence in COPD patients. Methods: This study was a study of 30 moderate-severe COPD patients. All patients were evaluated by a pulmonologist and underwent polysomnography before participating in the study. For this study, we selected only ex-smokers and patients with sleep apnea were referred to the sleep clinic. These participants were prospectively recruited and not selected based on program completion. Before the start of the program, sleep quality and daytime somnolence of the participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), respectively. Rehabilitation program consisted of muscular training sessions conducted at the gym 3 times per week for 12 weeks. After rehabilitation program, the patients were reassessed and their sleep quality and daytime somnolence were reevaluated using the PSQI and the ESS, respectively. Results: Before rehabilitation, PSQI evaluation revealed that 73% of the participants had poor sleep quality, and ESS evaluation showed that 86.7% of the participants experienced daytime somnolence. After pulmonary rehabilitation, the PSQI specifically improved in terms of subjective sleep quality and sleep duration (< 0.001), habitual sleep efficiency (0.001), and sleep latency and sleep alterations (0.002) and there was also improvement in the ESS (< 0.001). Conclusion: Pulmonary rehabilitation program of gradually increasing intensity has the potential to provide sleep-related benefits to patients with COPD who have poor sleep quality and daytime somnolence. Trial registration: Registro Brasileiro de Ensaios Clínicos (ReBEC) RBR62b4z2.

scholarly journals Impact of pulmonary rehabilitation in sleep in COPD patients measured by actigraphy

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248466
Author(s):  
Suman B. Thapamagar ◽  
Kathleen Ellstrom ◽  
James D. Anholm ◽  
Ramiz A. Fargo ◽  
Nagamani Dandamudi
Keyword(s):  
Sleep Quality ◽  
Pulmonary Rehabilitation ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Copd Patients ◽  
Before And After ◽  
Sleep Parameters

Introduction Chronic obstructive pulmonary disease (COPD) patients have poor sleep quality, longer time to sleep onset and frequent nocturnal awakenings. Poor sleep quality in COPD is associated with poor quality of life (QoL), increased exacerbations and increased mortality. Pulmonary rehabilitation (PR) improves functional status and QoL in COPD but effects on sleep are unclear. PR improves subjective sleep quality but there is paucity of objective actigraphy data. We hypothesized that actigraphy would demonstrate subjective and objective improvement in sleep following PR. Paired comparisons (t-test or Wilcoxon-signed-rank test) were performed before and after PR data on all variables. Methods This retrospective study of COPD patients undergoing PR utilized actigraphy watch recordings before and after 8-weeks of PR to assess changes in sleep variables including total time in bed (TBT), total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), wakefulness after sleep onset (WASO) and total nocturnal awakenings. A change in Pittsburg Sleep Quality Index (PSQI) was a secondary outcome. PSQI was performed before and after PR. Results Sixty-nine patients were included in the final analysis. Most participants were male (97%), non-obese (median BMI 27.5, IQR 24.3 to 32.4 kg/m2) with an average age of 69 ± 8 years and 71% had severe COPD (GOLD stage 3 or 4). Prevalence of poor sleep quality (PSQI ≥5) was 86%. Paired comparisons did not show improvement in actigraphic sleep parameters following 8-weeks PR despite improvements in 6-min-walk distance (6MWD, mean improvement 54 m, 95% CI 34 m to 74 m, p<0.0001) and St. George’s Respiratory Questionnaire scores (SGRQ, mean improvement 7.7 points, 95% CI 5.2 to 10.2, p<0.0001). Stratified analysis of all sleep variables by severity of COPD, BMI, mood, mental status, 6-MWD and SGRQ did not show significant improvement after PR. In Veterans with poor sleep quality (PSQI ≥ 5), PR improved subjective sleep quality (PSQI, mean difference 0.79, 95% CI 0.07 to 1.40, p = 0.03). Conclusions Pulmonary rehabilitation improved subjective sleep quality in Veterans who had poor sleep quality at the beginning of the PR but did not improve objective sleep parameters by actigraphy. Our findings highlight the complex interactions among COPD, sleep and exercise.

scholarly journals Sleep quality in stable chronic obstructive pulmonary disease patients in Zagazig University Hospitals, Egypt

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Adel H. A. Ghoneim ◽  
Mohamed S. El-Gammal ◽  
Yasmeen R. Ahmed ◽  
Doaa M. Gad
Keyword(s):  
Sleep Quality ◽  
Sleep Disordered Breathing ◽  
Chronic Obstructive ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Pulmonary Disease ◽  
Breathing Disorders ◽  
Copd Patients ◽  
Obstructive Sleep

Abstract Background Chronic obstructive pulmonary disease (COPD) causes changes in sleep quality with accompanied nocturnal drops in oxygen saturation leading to cardiac dysrhythmias, pulmonary hypertension, and more arousal. However, this sleep disturbance is an aspect of COPD that is still under evaluation. Therefore, this work is designed to detect sleep quality with type and frequency of sleep-related breathing disorders in stable COPD patients. Results This is a cross-sectional study that included 60 stable COPD patients. Full night polysomnographies were performed to all patients with assessment of their sleep quality and presence of sleep-disordered breathing. The studied patients were classified into two groups: group I (COPD with good sleep quality) and group II (COPD with poor sleep quality). The results revealed that the more severe the COPD degree, the worse the sleep quality parameters represented by sleep latency, sleep efficiency, and arousal index with a significant statistical difference (P < 0.05). Furthermore, a highly significant statistical difference was noticed regarding time spent in REM sleep among poor sleep quality patients with different grades of severity (P = 0.003). Additionally, obstructive sleep apnea hypopnea syndrome was the most frequent sleep-disordered breathing (65%), followed by nocturnal oxygen desaturation (17%) among poor quality sleeper. Conclusion Abnormal sleep quality is more common in moderate and severe COPD patients. Obstructive sleep apnea is the most frequent sleep-related breathing disorders among COPD patients. Increased BMI%, higher Berlin scores, and lower values of PaO2 and FOSQ-10 scores are strong predictors of poor sleep quality among COPD patients.

scholarly journals PULMONARY REHABILITATION PROGRAM – AN IMMINENT NEED FOR COPD

2017 ◽  
Vol 6 (1) ◽  
pp. 3
Author(s):  
Saad Saleem
Keyword(s):  
Pulmonary Rehabilitation ◽  
Obstructive Lung Disease ◽  
Health Care Organizations ◽  
Chronic Obstructive Lung Disease ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Copd Patients ◽  
Essential Components ◽  
Global Initiative ◽  
Pulmonary Rehabilitation Program

PR program is currently being offered in a number of hospitals in Pakistan but unfortunately, ATS/ERS defined PR programs, as structured in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are beyond the resources of health–care organizations and, consequently, are inaccessible or unavailable to the majority of the COPD patients. Moreover Pakistan has inadequate funds for patient care and is also deficient in the logistics for complex and multidisciplinary programs of PR according to the suggested guidelines. Hence, there is a need for more authenticated and basic programs that contain the essential components of pulmonary rehabilitation.

Maintaining Effects of Pulmonary Rehabilitation at Home in Chronic Obstructive Pulmonary Disease: A Systematic Literature Review

2021 ◽  
pp. 108482232199037
Author(s):  
Duarte Pinto ◽  
Lissa Spencer ◽  
Soraia Pereira ◽  
Paulo Machado ◽  
Paulino Sousa ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Literature Review ◽  
Pulmonary Rehabilitation ◽  
Rehabilitation Program ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Maintenance Strategies ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Pulmonary Rehabilitation Program

To systematize strategies that may support patients with Chronic Obstructive Pulmonary Disease to maintain the effects of pulmonary rehabilitation over time. This systematic literature review was conducted, and the evidence was electronically searched in the Web of Science, Scopus, and EBSCO databases. This review included randomized controlled clinical trials, published until September 2019, that addressed components of an unsupervised home-based pulmonary rehabilitation program, maintenance strategies following outpatient pulmonary rehabilitation programs, as well as data on outcomes for quality of life, exercise performance, and dyspnea. A final sample of 5 articles was obtained from a total of 1693 studies. Data for final synthesis were grouped into 2 categories: components of unsupervised home-based pulmonary rehabilitation programs and maintenance strategies. An unsupervised home-based pulmonary rehabilitation program should consist of an educational component, an endurance training component, and a strength training component. When patients are transferred to the home environment, it is important to include more functional exercises specifically adapted to the patient’s condition, goals, and needs.

scholarly journals Association between depression and sleep quality in patients with systemic lupus erythematosus: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Rulan Yin ◽  
Lin Li ◽  
Lan Xu ◽  
Wenjie Sui ◽  
Mei’e Niu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Sleep Quality ◽  
Lupus Erythematosus ◽  
Sleep Disturbances ◽  
Cochrane Library ◽  
Poor Sleep ◽  
Moderate Correlation ◽  
Systemic Lupus ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality

Abstract Background Currently, there is no consistent understanding of the relationship between depression and sleep quality in patients with systemic lupus erythematosus (SLE). This study aimed to explore the correlation between depression and sleep quality in SLE patients. Methods Five English (PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL) databases were systematically searched from inception to January 12, 2021. Two authors independently screened publications and extracted data according to set inclusion and exclusion criteria. Statistical analyses were performed with STATA 16.0. Data were pooled using a random-effects model. Results A total of 9 identified studies matched the inclusion criteria, reporting on 514 patients with SLE in the analysis. A moderate correlation of depression with sleep quality was found (pooled r = 0.580 [0.473, 0.670]). Compared to good sleepers, patients with SLE and poor sleep quality had higher levels of depression (standardized mean difference =  − 1.28 [− 1.87, − 0.69]). Depression was associated with subjective sleep quality (r = 0.332 [0.009, 0.592]), sleep latency (r = 0.412 [0.101, 0.649]), sleep disturbances (r = 0.405 [0.094, 0.645]), daytime dysfunction (r = 0.503 [0.214, 0.711]), the four dimensions of Pittsburgh Sleep Quality Index (PSQI), while no significant correlation was found in the other three PSQI dimensions. Conclusion Depression had a moderate correlation with sleep quality in patients with SLE. Patients with poor sleep quality tended to have higher level of depression than that of good sleepers. Awareness of the correlation may help rheumatology physicians and nurses to assess and prevent depression and improve sleep quality in patients with SLE.

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