Evaluation of Sleep Disorders in Chronic Obstructive Pulmonary Disease Patients by Subjective Questionnaire and Their Correlation with FEV1, PaO2, and PaCO2
Ram B Sah, Anchal Teotiya
Forced vital capacity in 1 second, Global sleep assessment questionnaire, Partial pressure of arterial carbon dioxide, Partial pressure of arterial oxygen, Patient health quality 4.
Citation Information :
Sah RB, Teotiya A. Evaluation of Sleep Disorders in Chronic Obstructive Pulmonary Disease Patients by Subjective Questionnaire and Their Correlation with FEV1, PaO2, and PaCO2. Indian Sleep Med 2017; 12 (4):60-63.
Introduction/objectives: Sleep disorders are common in chronic obstructive pulmonary disease (COPD). The commonly seen sleep disorders in COPD that can worsen the quality of sleep are insomnia, restless leg syndrome (RLS), obstructive sleep apnea (OSA), and nocturnal oxygen desaturation (NOD). However, these sleep disorders have not been studied in India.
Aim: (1) To determine the prevalence of sleep disorder in COPD patients with global sleep assessment questionnaire (GSAQ). (2) To confirm the presence of insomnia, depression, and RLS. (3) To assess the sensitivity and specificity of GSAQ with respect to insomnia, depression, and RLS. (4) Correlation of GSAQ with age, body mass index (BMI), forced expiratory volume in 1 second (FEV1), and partial pressure of arterial oxygen (PaO2) and carbon dioxide (PaCO2).
Materials and methods: A prospective study of 60 clinically stable COPD patients was undertaken. Patients were screened for sleep disturbances with the help of the GSAQ. All participants were further assessed with the insomnia, Unpleasant Sensation, Rest induced, Gets relieved on movement, Evening (URGE), and patient health quality 4 (PHQ4) questionnaire. Spirometry and arterial blood gas (ABG) analysis were done in all the patients.
Results: In the enrolled 60 patients, male:female ratio was 53:7. 33 (55%) and the patients were found to have positive GSAQ. Among them, 22 (66.67.%), 17 (57.57%), and 23 (69.69%) patients were suspected to have insomnia, RLS, and depression respectively. Some of them had overlap of two disorders. The overall sensitivity and specificity of GSAQ obtained by confirmatory questionnaire were 84.61 and 95.23% respectively. The difference in the mean age, BMI, PaO2, and PaCO2 among GSAQ-positive and egative patients was nonsignificant (p > 0.05). Though low BMI was present, hypercapnea and hypoxia were more commonly present in the GSAQ-positive group. The mean FEV1 (absolute value) in GSAQ-positive group was: 1.23 ± 0.53 L/min, while in the GSAQ-negative group, it was 1.68 ± 0.62 L/min. The difference was statistically significant (p – 0.0003) for FEV1 and its low value was found correlating with high chances of sleep disorders (GSAQ positive).
Conclusion: Sleep disorders are commonly seen in COPD patients. The majority of the patients had sleep disturbance due to insomnia. Patients with lower FEV1 have higher chances of sleep disturbance.
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