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

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.

2020 ◽  
Vol 8 (4) ◽  
pp. 200-201
Author(s):  
Guzel Gafina ◽  
Marc Spielmanns

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.


2021 ◽  
Author(s):  
Yvonne Kutzer ◽  
Lisa Whitehead ◽  
Eimear Quigley ◽  
Shih Ching Fu ◽  
Mandy Stanley

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705


2018 ◽  
Vol 11 (1) ◽  
pp. 369-375 ◽  
Author(s):  
Sofa D. Alfian ◽  
Henry Ng ◽  
Dika P. Destiani ◽  
Rizky Abdulah

Introduction: Poor subjective sleep quality in undergraduate students has not been widely studied in Bandung city, Indonesia. Poor sleep quality has been related to a number of risk factors for poor health outcomes. Objective: To analyze the association between psychological distress and subjective sleep quality. Methods: A cross sectional survey was done in one of the universities of Bandung city, Indonesia. Data were collected from 290 undergraduate students selected through consecutive sampling. Pittsburg Sleep Quality Index (PSQI) and Kessler-10 questionnaire were administered. Results: The prevalence of psychological distress was well (43.1%), mild (28.6%), moderate (20.7%), and severe (7.6%). The overall sleep quality was poor and good in 84.5% and 15.5% of the students. There was a significant association between psychological distress and poor sleep quality (p=0.006). The multivariate analysis suggested that psychological distress was a predictor of poor sleep quality (OR 1.991; 95% CI, 1.311−3.026). Conclusion: There is a need for an awareness of the college resources to help manage the stress levels of students through effective coping strategy-related study habits.


2019 ◽  
Author(s):  
Lu Long ◽  
Jia Liu ◽  
Jin Yan ◽  
Jian fei Xie ◽  
Huan Liu ◽  
...  

Abstract Background Although evidences showed that sleep disorder is common in patient with end stage renal disease (ESRD), less is known about their sleep quality after early post-kidney transplantation (kTx) especially in Intensive Care Unite (ICU). Thus, the purpose of this study is to investigate sleep quality of kTx recipients in ICU and explore factors related poor sleep, second, to measure the correlation of subjective sleep quality and sleep architecture assessed by PSG in kTx recipients. Methods This study recruited participants from ESRD patients registered in transplantation waiting list at the third xiangya hospital of central south university in China. Participants required to complete the Pittsburgh sleep quality index(PSQI) and demographic questionnaire as baseline data and received one night of Polysomnography (PSG) in the ICU within 96 hours of surgery, during which time sound and light data were monitored. After that Richards Campbell sleep questionnaires (RCSQ) also need completed. Results 26 participants self-reported sleep quality and sleep efficiency based on RCSQ was at middle level (49.2 ± 25.6mm), and 14/26(53.8%) kTx recipients in ICU were poor sleepers defined by RCSQ <50. PSG showed that most kTx recipients in ICU had shallow sleep with mainly stage 2 sleep time (80.90 ±70.10 min), lower total sleep time (136.50 ±86.41 min), higher awakening frequency after sleep onset (8.87 ±5.92 times) and long awaken time (94.67 ±75.09 min) when a sleep disruption occured. multiple linear regression analysis showed that self-reported noise and pain were the significant factor affecting sleep(P < 0.05).Conclusion Subjective sleep quality based on RCSQ scored better than objective one measured by PSG in kTx recipients, sleep disruption always remained a substantial problem and affected by self-reported noise and pain.


Thorax ◽  
2001 ◽  
Vol 56 (7) ◽  
pp. 513-518
Author(s):  
N McArdle ◽  
R Kingshott ◽  
H M Engleman ◽  
T W Mackay ◽  
N J Douglas

BACKGROUNDThe sleep apnoea/hypopnoea syndrome (SAHS) causes snoring, apnoeas, and restlessness during sleep which partners frequently complain about. A study was undertaken to determine the impact on partners of SAHS and of treatment of the patient with continuous positive airway pressure (CPAP).METHODSForty nine partners and patients with SAHS booked for CPAP treatment completed in house and validated questionnaires (Pittsburgh sleep quality index, Short Form 36 self-reported health status) before the patient started treatment. Twenty three couples in whom the index SAHS patient had no driving problems were recruited to a randomised crossover trial with 1 month limbs of CPAP and placebo capsule. At the end of each limb the partners' sleep was monitored by home polysomnography (PSG) and questionnaires were completed.RESULTSBefore treatment partners frequently reported moderate to severe disturbance from patient snoring/apnoeas/restlessness and had poor sleep quality and self-reported health status. In the crossover study (22 completed) the partners' objective sleep quality did not differ between CPAP and placebo, but they reported benefit from treatment of the patients with CPAP in subjective sleep quality (p=0.05) and disturbance to sleep (p=0.03). The reported change in partners' sleep quality between pre-study and following CPAP treatment correlated positively with CPAP use (r=0.5, p=0.01).CONCLUSIONSPartners of patients with SAHS have poor sleep quality and self-reported health status but only subjective sleep quality benefits from treatment of the patient with CPAP.


2020 ◽  
Author(s):  
Min-Fang Hsu ◽  
Kang-Yun Lee ◽  
Tsung-Ching Lin ◽  
Wen-Te Liu ◽  
Shu-Chuan Ho

Abstract Background: As a complex phenomenon, sleep quality is difficult to objectively define and measure, and multiple factors related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, feature prominently in older adult populations. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to associate sleep quality with health-related physical fitness factors, depressive symptoms, and the number of chronic diseases in the middle-aged and elderly.Methods: We enrolled a total of 283 middle-aged and elderly participants from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment included anthropometric and physical fitness parameters. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, and descriptive statistics and logistic regression analysis were used for the analyses.Results: Overall, 27.9% of participants in this study demonstrated poor sleep quality (with a PSQI score of >5), 10.2% of study participants frequently used sleep medication to help them fall asleep, and 6.0% reported having significant depressive symptoms (with a CES-D score of ≥10). There are two major findings: (1) depression symptoms, the number of chronic diseases, self-rated health, and arthritis were significantly associated with a poor sleep quality, and (2) the 2-min step test was associated with longer sleep latency. These results confirmed that the 2-min step was associated with a longer sleep latency among the health-related physical fitness items.Conclusions: Our study found that depressive syndrome, chronic disease numbers, a poor self-rated health status, and arthritis were the main risk factors that influenced subjective sleep quality.


2020 ◽  
Author(s):  
Min-Fang Hsu ◽  
Kang-Yun Lee ◽  
Tsung-Ching Lin ◽  
Wen-Te Liu ◽  
Shu-Chuan Ho

Abstract Background: As a complex phenomenon, sleep quality is difficult to objectively define and measure, and multiple factors related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, feature prominently in older adult populations. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to associate sleep quality with health-related physical fitness factors, depressive symptoms, and the number of chronic diseases in the middle-aged and elderly.Methods: We enrolled a total of 283 middle-aged and elderly participants from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment included anthropometric and physical fitness parameters. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, and descriptive statistics and logistic regression analysis were used for the analyses.Results: Overall, 27.9% of participants in this study demonstrated poor sleep quality (with a PSQI score of >5), 10.2% of study participants frequently used sleep medication to help them fall asleep, and 6.0% reported having significant depressive symptoms (with a CES-D score of ≥10). There are two major findings: (1) depression symptoms, the number of chronic diseases, self-rated health, and arthritis were significantly associated with a poor sleep quality, and (2) the 2-min step test was associated with longer sleep latency. These results confirmed that the 2-min step was associated with a longer sleep latency among the health-related physical fitness items.Conclusions: Our study found that depressive syndrome, chronic disease numbers, a poor self-rated health status, and arthritis were the main risk factors that influenced subjective sleep quality.


2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A24-A24
Author(s):  
A Barnes ◽  
P Spizzo ◽  
R Mountifield ◽  
P Bampton ◽  
J Andrews ◽  
...  

Abstract Background Poor sleep quality has been associated with active inflammatory bowel disease (IBD) in several studies. This review examines sleep quality in people with active IBD and in those in remission, with meta-analyses performed, considering subjective and objective sleep quality and IBD activity. Methods Electronic databases were searched from inception to December 1st 2020. A random effects model was used with separate meta-analyses performed for objective and subjective sleep and IBD activity, considering sleep quality in active and inactive IBD. Results 19 studies were included in the qualitative review representing 4972 IBD patients. Subjective IBD activity (11 studies) was associated with subjective sleep quality with pooled odds ratio (OR) for subjective poor sleep in active IBD compared to remission of 3.04 (95% CI 2.41–3.83). Including only studies with objective sleep measures (5 studies), sleep efficiency was lower in those self-reporting active IBD and time awake post sleep onset was higher in those with active IBD. Objective IBD activity was associated with subjective poor sleep (4 studies), with pooled OR of 6.64 95% CI (3.02 – 14.59). Insufficient data was available to consider objective IBD activity and objective sleep quality. Conclusion IBD activity is associated with poor sleep using subjective and objective measures of sleep quality. This poor sleep manifests as decreased sleep efficiency and increased number of waking episodes post sleep onset. The relationship between objective IBD activity and sleep requires further investigation.


2012 ◽  
Vol 24 (11) ◽  
pp. 1827-1835 ◽  
Author(s):  
Chiara Cupidi ◽  
Sabrina Realmuto ◽  
Gianluca Lo Coco ◽  
Antonio Cinturino ◽  
Simona Talamanca ◽  
...  

ABSTRACTBackground: Knowledge about sleep complaints of caregivers of patients with Alzheimer's disease (AD) and Parkinson's disease (PD) is limited, and we lack information about the relationship between caregivers’ sleep problems and their quality of life (QoL).Methods: We evaluated subjective sleep quality and its relationship to QoL in a group of 80 caregivers of patients with AD (ADCG, n = 40) and PD (PDCG, n = 40), and in 150 controls. Information about night-time complaints was collected using the Pittsburgh Sleep Quality Index (PSQI). QoL was measured using the McGill QoL Questionnaire.Results: Eighteen ADCG (45%), 22 PDCG (55%), and 45 (30%) controls reported poor sleep quality. Mean global PSQI score of PDCG (6.25 ± 3.9) was not significantly different from that of ADCG (5.8 ± 3.5; p = 0.67). However, both PDCG and ADCG scored significantly higher than control group (4.3 ± 3.1; p < 0.01). ADCG frequently reported difficulties falling asleep (72.5%) and disturbed sleep (100%). PDCG reported reduced subjective sleep quality (80%) and increased sleep disturbances (100%). Poor sleep quality was associated with depressive symptoms and correlated with QoL in caregivers of both groups, particularly the psychological symptoms domain.Conclusions: Among caregivers of patients with AD and PD, poor sleep quality is frequent and significantly linked to QoL and depressive symptoms. Identifying the nature of sleep disturbances not only in patients but also in their caregivers is important as appropriate treatment may lead to a better management of the needs of families coping with these patients.


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