Abstract
Prior research has shown that individuals with obstructive lung disease are at risk for sleep fragmentation and poor sleep quality. We postulated that patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (known as overlap syndrome) who have more severe lung disease, as measured by lung hyperinflation (inspiratory capacity/total lung capacity), would have greater sleep disturbances independent of traditional measures of sleep apnea. We performed a retrospective chart review of consecutive patients evaluated and treated in an academic pulmonary clinic for overlap syndrome. Pulmonary function tests and polysomnogram data were collected. Thirty patients with overlap syndrome were included in the analysis. We found significant univariable associations between sleep efficiency and apnea/hypopnea index (β -0.285, p 0.01) and between sleep efficiency and lung hyperinflation (β 0.654, p 0.03). Using multivariable linear regression, the relationship between sleep efficiency and lung hyperinflation remained significant (β 1.13, p 0.02) after adjusting for age, sex, body mass index, apnea/hypopnea index, FEV1 predicted, oxygen saturation nadir, medications, and cardiac disease. We conclude that increased severity of hyperinflation is associated with worse sleep efficiency, independent of apnea and nocturnal hypoxemia. The mechanisms underlying this observation are uncertain. We speculate that therapies aimed at reducing lung hyperinflation may improve sleep quality in patients with overlap syndrome.
Original language | English (US) |
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Pages (from-to) | 441-445 |
Number of pages | 5 |
Journal | COPD: Journal of Chronic Obstructive Pulmonary Disease |
Volume | 6 |
Issue number | 6 |
DOIs | |
State | Published - 2009 |
Funding
Dr. Jeff Kwon and Dr. Brandon Lu have received grant support from GlaxoSmithKline Inc. and honoraria for services on an advisory board for Takeda Pharmaceuticals. Dr. Ravi Kalhan has received honoraria for service on the speakers’ bureaus for Gla-xoSmithKline, Boehringer-Ingelheim, Pfizer, and Astra-Zeneca as well as serving as a consultant to Boehringer-Ingelheim, Takeda Pharmaceuticals, Astra-Zeneca, and Dey Pharmaceuticals. He has received grant support from GlaxoSmithKline. Dr. Lisa Wolfe has received honoraria for service on the speakers’ bureaus for Hill-Rom and Cephelon as well as serving as a consultant to and has received grant support from ResMed.
Keywords
- COPD
- Hyperinflation
- Obstructive Sleep Apnea
- Sleep
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine