Introduction
Methods
Study design and subjects
Data collection
Definition and measure
Assessment for symptom change
Exacerbations
Statistical analysis
Results
Participant characteristics
Variables | Total | Bad sleeper | Good sleeper | P- value |
---|---|---|---|---|
Number of patients, n (%) | 461(100.0) | 228(49.5) | 233(50.5) | |
Age (years)a | 63.1 ± 8.2 | 64.3 ± 8.5 | 62.1 ± 9.0 | 0.016 |
Sexb | 0.287 | |||
Male | 410(88.9) | 199(87.3) | 211(90.6) | |
Female | 52(11.1) | 29(12.7) | 22(9.4) | |
Educationb | 0.116 | |||
Primary school | 158(34.3) | 84(36.8) | 74(31.8) | |
Junior high school | 189(41.0) | 97(42.5) | 92(39.5) | |
High school | 77 (16.7) | 35(15.4) | 42(18.0) | |
University | 37(8.0) | 12 (5.3) | 25 (10.7) | |
BMI (kg/m2)a | 22.6 ± 3.1 | 22.3 ± 3.2 | 22.9 ± 3.4 | 0.096 |
Marry statusb | 0.354 | |||
married | 351 (95.4) | 219 (96.1) | 222(95.2) | |
unmarried | 17(4.6) | 9(3.9) | 11 (4.8) | |
Smoking stateb | 0.614 | |||
Current smoker | 178(38.8) | 84(36.9) | 95(40.7) | |
Ex-smoker | 210(45.6) | 107(46.9) | 103(44.2) | |
Non-smoker | 72(16.6) | 37(16.2) | 35(16.0) | |
Biofuel exposureb | 0.292 | |||
Yes | 169(36.7) | 90(39.3) | 79(34.1) | |
No | 292(63.3) | 138(60.7)) | 154 (65.9) | |
Occupationalb | 0.608 | |||
Yes | 182(39.4) | 90(39.3) | 79(39.5) | |
No | 279(60.6) | 138 (60.7)) | 154 (60.5) | |
CATa | 12.4 ± 6.8 | 14.6 ± 6.3 | 9.8 ± 6.0 | <0.001 |
mMRCb | 2 (1) | 2(2) | 2(1) | <0.001 |
0–1 | 179(38.8) | 71(31.1) | 108(46.4) | 0.001 |
2–4 | 282(61.2) | 157(68.9) | 125(53.6) | |
CCQa | 18.4 ± 8.2 | 20.3 ± 7.7 | 17.7 ± 7.4 | <0.001 |
FEV1(L)c | 1.4(0.90) | 1.33(0.73) | 1.49(0.99) | 0.031 |
FEV1 (% predicted)c | 54.40(31.2) | 52.5(28.7) | 56.0(31.7) | 0.178 |
FEV1/FVCc | 50.9(19.9) | 47.1(19.7) | 51.3(23.9) | 0.030 |
Exacerbations in the past yearc | 0(1) | 0(1) | 0(1) | 0.258 |
Exacerbations in the past yearb | 0.404 | |||
0 | 230(49.9) | 109(47.8) | 121 (51.9) | |
1 | 122(26.4) | 59 (25.9) | 63 (27.0) | |
≥ 2 | 109(23.7) | 60 (26.3) | 49(21.1) | |
GOLD groupb | <0.001 | |||
A | 81(17.6) | 23(10.1) | 58(24.9) | |
B | 195(42.3) | 110(48.2) | 85(36.5) | |
C | 25(5.4) | 5(2.2) | 20(8.6) | |
D | 160(34.7) | 90(39.5) | 70(30.0) | |
Treatmentb | 0.012 | |||
LAMA | 91(19.7) | 33(14.5) | 58(24.9) | |
LABA + ICS | 62(13.4) | 31(13.6) | 31(13.3) | |
LABA + LAMA | 61(13.2) | 37(16.2) | 24(10.3) | |
LABA + LAMA + ICS | 217(47.1) | 106(46.5) | 111(47.6) | |
Others | 30(6.5) | 21(9.2) | 9(3.9) | |
PSQI scorea | 5.8 ± 3.4 | 8.5 ± 2.7 | 3.2 ± 1.4 | <0.001 |
Sleep efficiencya | 1.6 ± 1.1 | 2.3 ± 0.9 | 0.8 ± 0.6 | <0.001 |
Sleep qualitya | 2 ± 1.4 | 3.2 ± 1.2 | 1.3 ± 0.6 | <0.001 |
Daily disturbancea | 2.0 ± 1.0 | 2.9 ± 1.1 | 1.1 ± 0.7 | <0.001 |
Risk of OSASb | 0.892 | |||
positive | 93 (20.1) | 46 (20.2) | 47 (20.0) | 0.890 |
negative | 368 (79.9) | 182 (79.8) | 186 (80.0) | |
Anxietyb | 31 (6.8) | 22 (9.8) | 9 (3.8) | 0.030 |
Depresionb | 11 (2.4) | 8 (3.3) | 3 (1.1) | 0.053 |
Sleep quality and symptom change
Variables | Total N = 461 | Bad sleeper N = 228 | Good sleeper N = 233 | P-value |
---|---|---|---|---|
CAT at 6th montha | 10.7 ± 6.1 | 13.6 ± 5.6 | 7.9 ± 4.7 | <0.001 |
Change in CATc | 1(8) | 0(9) | 2(6) | 0.021 |
MCID of CAT b | ||||
Yes | 224(48.6) | 93(40.8) | 131(56.2) | 0.001 |
No | 237(51.4) | 135(59.2) | 102(43.6) | |
Exacerbations in the one yearc | 0(1) | 0(1) | 0(0) | <0.001 |
Exacerbation in the one year b | <0.001 | |||
Yes | 181(39.3) | 108(47.4) | 73(31.3) | |
No | 280(60.7) | 120(52.6) | 160(68.7) | |
Severe exacerbation in the one year b | 0.017 | |||
Yes | 117(25.4) | 69(30.3) | 48(20.6) | |
No | 344(74.6) | 159(69.7) | 185(79.4) | |
Frequent exacerbation in the one year b | 0.008 | |||
Yes | 65(14.1) | 42(18.4) | 23(9.9) | |
No | 396(85.9) | 186(81.6) | 210(90.1) |
Variable | Univariate | Multivariate | ||||
---|---|---|---|---|---|---|
Factors | OR | 95%CI |
P
-value | OR | 95%CI |
P
-value |
Age (years) | 1.013 | 0.991–1.036 | 0.245 | |||
Sex (Male versus Female) | 0.890 | 0.502–1.607 | 0.717 | |||
BMI (kg/m2) | 0.958 | 0.895–1.025 | 0.216 | |||
Smoking state | ||||||
Current smoker | Reference | |||||
Ex-smoker | 1.386 | 0.774–2.477 | 0.271 | |||
Non-smoker | 0.995 | 0.582–1.703 | 0.986 | |||
Biofuel exposure, (Yes versus No) | 1.364 | 1.126–1.579 | 0.000 | 1.102 | 1.009–1.214 | 0.036 |
Occupational exposure (Yes versus No) | 1.055 | 0.717–1.522) | 0.786 | |||
CAT score | 1.179 | 1.136–1.225 | <0.001 | 1.372 | 1.274–1.477 | <0.001 |
mMRC (Median, IQR) | ||||||
0–1 | Reference | |||||
2–4 | 1.021 | 1.002–1.075 | 0.008 | |||
CCQ score | 1.077 | 1.049–1.106 | <0.001 | |||
GOLD group | ||||||
A | Reference | |||||
B | 2.413 | 1.616–2.907 | 0.000 | |||
C | 1.043 | 0.583–1.965 | 0.934 | |||
D | 1.921 | 1.423–2.214 | 0.001 | |||
Exacerbations in the past year, (Yes versus No) | 1.321 | 0.914–1.908 | 0.139 | |||
Treatment | ||||||
LAMA | Reference | |||||
LABA + ICS | 1.011 | 0.521–1.961 | 0.975 | |||
LABA + LAMA | 1.988 | 1.216–3.496 | 0.011 | |||
LABA + LAMA + ICS | 1.894 | 1.148–3.125 | 0.012 | |||
PSQI ≤ 5 | 2.364 | 1.388–3.268 | 0.001 | 3.112 | 1.873–4.711 | <0.001 |
Risk of OSAS | 1.002 | 0.789–1.314 | 0.852 | |||
Anxiety | 0.957 | 0.568–1.127 | 0.431 | |||
Depresion | 1.018 | 0.498–1.637 | 0.612 |
Symptom improvement of different GOLD groups or different inhalation therapies in COPD patients with different sleep quality
Sleep quality and risk of future exacerbation
Moderate to severe exacerbation | Frequent exacerbation | Severe exacerbation | ||||
---|---|---|---|---|---|---|
HR (95CI%) | P- value | HR (95CI%) | P- value | HR (95CI%) | P- value | |
PSQI>5* | 1.692(1.213–2.357) | 0.002 | 1.766(1.115–2.797) | 0.015 | 1.124(1.018–1.301) | 0.031 |
PSQI# | 1.070(1.030–1.111) | <0.001 | 1.080(1.020–1.142) | 0.008 | 1.010(0.983–1.026) | 0.102 |