Sleep problems are frequently reported in patients with COPD but are underrecognized as prognostic markers in clinical practice.
That’s according to the paper, “Silent Nights, Restless Lungs: Sleep Quality and Associated Factors Among COPD Patients in Vietnam — A Cross-Sectional Study,” published in Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation.
The paper’s authors wrote that large cohort studies have shown that sleep disturbances are independently associated with increased risk of acute COPD exacerbations, accelerated decline in lung function, reduced physical activity and higher all-cause mortality. Despite this, “sleep disturbances constitute a major but often underrecognized comorbidity in patients with COPD,” they said.
To further examine this link, the researchers conducted a cross-sectional study at the COPD outpatient clinic of Bach Mai Hospital in Hanoi, Vietnam. Participants were aged 40 and older with a physician-confirmed diagnosis of COPD and attended routine follow-up visits. All participants were clinically stable outpatients not receiving long-term oxygen therapy, home noninvasive ventilation or continuous positive airway pressure treatment.
Sleep quality was assessed using the Vietnamese version of the Pittsburgh Sleep Quality Index (PSQI), while dyspnea severity was evaluated using the Modified Medical Research Council (mMRC) scale.
The cohort consisted of mostly male, former smokers aged 60 and above with a high COPD symptom burden.
The study confirmed that sleep disturbance is a significant problem in COPD. More than 85% of participants reported poor sleep quality, which was similar to findings in other studies from the United States and India. In addition, the study found that those with COPD had nearly 19 times higher odds of poor sleep than those without COPD.
“It is clear that sleep disturbance needs to be given more attention in the multidisciplinary management of COPD patients, which is often overlooked by clinicians,” the researchers wrote.
The consistency of the data from this study and previous studies suggests that poor sleep quality is a pervasive issue among COPD patients regardless of geographic or health care setting. Dyspnea severity and airflow limitation were among the significant contributing factors to sleep impairment.
“These results underscore that both symptom severity and physiological impairment are key drivers of sleep disturbance in COPD,” the authors wrote. “They highlight the need for clinicians to routinely evaluate sleep quality — particularly in patients with high COPD Assessment Test (CAT) scores or mMRC grades, marked airflow limitation or longstanding disease — so that targeted symptom control, dyspnea management and behavioral interventions can be integrated into comprehensive COPD care.”
