• Masanori Azuma, Kazuo Chin, Chikara Yoshimura, Misa Takegami, Ken-Ichi Takahashi, Kensuke Sumi, Takaya Nakamura, Yukiyo Nakayama-Ashida, Itsunari Minami, Sachiko Horita, Yasunori Oka, Toru Oga, Tomoko Wakamura, Shun-Ichi Fukuhara, Michiaki Mishima, and Hiroshi Kadotani.
• Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
• Respiration. 2014 Jan 1; 88 (3): 234-43.

BackgroundThere are few reports about sleep disturbances in patients with chronic obstructive pulmonary disease (COPD) in Asian countries.ObjectivesTo investigate the associations between sleep-disordered breathing (SDB) with hypoxemia and sleep quality, including sleep duration, in patients with COPD, we measured SDB and sleep quality including the objective sleep duration determined by an actigraph and portable monitoring.MethodsA cross-sectional epidemiological health survey of 303 male employees (means ± SD: age 43.9 ± 8.2 years; BMI 24.0 ± 3.1) was conducted. Sleep quality was measured using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). A respiratory disturbance index (RDI) ≥5 indicated SDB.ResultsNineteen subjects (6.3%) had COPD. Among these, 11 (3.6%) had COPD with SDB (overlap syndrome). Sleep duration, ESS, and PSQI scores were not significantly different between COPD patients and normal control subjects. However, COPD patients had significantly longer sleep latency (p = 0.019), a lower sleep efficiency (p = 0.017), and a higher sleep fragmentation index (p = 0.041) and average activity (p = 0.0097) during sleep than control subjects. They also had a significantly higher RDI and more severe desaturation during sleep than control subjects (p < 0.01). The differences remained after adjustment for age and BMI but disappeared following adjustment for RDI.ConclusionsCOPD patients with even mild-to-moderate airflow limitations had nocturnal desaturation and RDI-related impaired sleep quality without significant symptoms.

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