Citation Information :
Deshpande AA, Jiandani MP, Athavale AU. Correlation of Sleep Quality with Cognition, Exercise Capacity, and Fatigue in Patients with Chronic Respiratory Diseases. Indian Sleep Med 2021; 16 (3):61-64.
Background: Sleep is an important component for person\'s well-being. It is a basic human need.1 Studies have reported increased incidence of cognitive errors and increased fatigue in sleep-deprived normal individuals after 8 hours of work.2 Sleep quality is known to be affected in COPD patients but less studied in other chronic respiratory diseases though the symptoms may be the same. This study aims to assess sleep quality in patients suffering from both COPD and non-COPD respiratory conditions and correlate sleep quality with cognition, exercise capacity, and fatigue in patients with chronic respiratory diseases.
Material and methodology: An observational cross-sectional study consisting of 142 stable chronic respiratory disease patients was conducted from September 2016 to March 2017. Sleep quality was evaluated using Pittsburgh sleep quality index (PSQI), cognition using montreal cognitive assessment (MoCA), exercise capacity was measured with incremental shuttle walk test, and fatigue with fatigue severity scale (FSS).
Results: Spearman\'s test was used to assess correlation of sleep quality with cognition, exercise capacity, and fatigue. Significant but very weak and poor inverse correlation of sleep quality was found with cognition and exercise capacity, respectively, whereas there was weak and linear correlation of sleep quality with fatigue. There was no significant difference in sleep quality of COPD and non-COPD patients as well as hypoxemic and non-hypoxemic patients.
Conclusion: Though there is very weak correlation of sleep quality with cognition, sleep quality is poor in 55.63% of patients and cognition is affected in 93.6% of patients (n = 133).
Clinical significance: Sleep quality should be assessed regularly as a part of primary assessment in all chronic respiratory disease patients.
Key Message: Evaluation of sleep quality must be included in routine assessment of patients with chronic respiratory diseases.
Valipour A, Lavie P, Lothaller H, et al. Sleep profile and symptoms of sleep disorders in patients with stable mild to moderate chronic obstructive pulmonary disease. Sleep Med 2011;12(4):367–372. DOI: 10.1016/j.sleep.2010.08.017.
Buysse DJ, Reynolds Ill CF, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1988;28(2):193–213. DOI: 10.1016/0165-1781(89)90047-4.
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53(4):695–699. DOI: 10.1111/j.1532-5415.2005.53221.x.
Valko PO, Barsetti CL, Bloch KE, et al. Validation of fatigue severity scale. Sleep 2008;31(11):1601–1607. DOI: 10.1093/sleep/31.11.1601.
Holland AE, Spruit MA, Singh SJ. How to carry out a field walking test in chronic respiratory disease. Breathe 2015;11(2):129–139. DOI: 10.1183/20734735.021314.
Dempsey JA, Wagner PD. Exercise-induced arterial hypoxemia. The American Physiological Society. J Appl Physiol 1999;87(6):1997–2006. DOI: 10.1152/jappl.1918.104.22.1687.
Chang CH, Chuang LP, Lin SW, et al. Factors responsible for poor sleep in chronic obstructive pulmonary disease. BMC Pulm Med 2016;16(1):118. DOI: 10.1186/s12890-016-0281-6.
Israel SA, Bliwise DL, Nørgaard JP. The effect of nocturia on sleep. Sleep Med Rev 2011;15(2):91–97. DOI: 10.1016/j.smrv.2010.03.002.
Hirshkowitz M. Normal human sleep: an overview. Med Clin N Am 2004;88(3):551–556. DOI: 10.1016/j.mcna.2004.01.001.
Fegyveres RA, Kairalla RA, Carvalho CRR, et al. Cognition and chronic hypoxia in pulmonary diseases. Dement Neuropsychol 2010;4(1): 14–22. DOI: 10.1590/S1980-57642010DN40100003.
Gupta PP, Sood S, Atreja A, et al. A comparison of cognitive functions in non-hypoxemic chronic obstructive pulmonary disease (COPD) patients and age-matched healthy volunteers using minimental state examination questionnaire and event-related potential, P300 analysis. Lung India 2013;30(1):5–11. DOI: 10.4103/0970-2113.106119.
Arar YG, Tunc A, Gungen BD, et al. The effects of depression, anxiety and sleep disturbances on cognitive impairment in patients with chronic obstructive pulmonary disease. Cogn Neurodyn 2017;11(6):565–571. DOI: 10.1007/s11571-017-9449-x.
Small S, Lamb M. Fatigue in chronic illness: the experience of individuals with chronic obstructive pulmonary disease and with asthma. J Adv Nurs 1999;30(2):469–478. DOI: 10.1046/j.1365-2648.1999.01102.x.
Ravary RB, Quint JK, Goldring JP, et al. Determinants and impact of fatigue in COPD patients. Respir Med 2009;103(2):216–223. DOI: 10.1016/j.rmed.2008.09.022.
Baltzan MA, Scott AS, Wolkove N, et al. Fatigue in COPD: Prevalence and effect on outcomes in pulmonary rehabilitation. Chron Respir Dis 2011;8(2):119–128. DOI: 10.1177/1479972310396737.