A Study On The Sleep Condition Of Stable And Acutely Exacerbated COPD Patients And The Relationship Of Sleep Disturbance And Clinical Symptoms

BackgroundChronic Obstructive Pulmonary Disease(COPD) is a common preventable andtreatable disease with persistent airflow limitation that is usually progressive, whichinfluence the health status and quality of life of thousands of people. Sleep is anaturally recurring state of human beings, during which the body is in aheightened anabolic state that help people recover. So that the abnormal state of sleepwill cause a variety of diseases. In recent years, scientists have found that the sleeparchitecture, sleep efficiency, nocturnal oxygen of COPD patients are changingbecause of the mentally and physically abnormal state.ObjectiveTo investigate the difference of polysomnographic results, sleep architecture,nocturnal oxygen, Pittsburgh sleep quality index between stable and acutelyexacerbated COPD and analyze the relationship of these parameters and diseaseprogress. As a result, to diagnose and prognose the development of COPD.MethodsWe randomly picked outpatients who were in the stable process of COPD for threemonths and inpatients who were newly diagnosed as AECOPD, all of whom werefrom The First Affiliated Hospital of Guangzhou Medical University, GuangzhouInstitute of Respiratory Disease.1. To proceed a lung function test of them and chose patients with results as follows:FEV1/FVC＜70%, FEV1/pre%＜50%, and negative for bronchial diastolic or excitation tests. Then took arterial blood gas analysisof AECOPD patients.2. To proceed a full-night polysomnography of these patients and recruited patientswhose AHI＞5/h. Then analyze the monitoring parameters and helped them finishESS score, PSQI, CAT and mMRC.3. Six months later, called them for follow-up visit and recorded the frequency ofAECOPD during this six months.Results1. Sixty men were recruited in this study, they were50-78years old, withFEV1/pre%33.9±10.7%.2. The total sleep time, sleep efficiency of stable COPD were greater than AECOPD,in the contrast, the sleep latency, awake time after sleep onset of the former wereshorter than the latter. And the sleep architecture is also different between the groups,with shorter period of N1and longer period of N2, N3in stable COPD, compared toAECOPD.3. The CAT, mMRC, PSQI of stable COPD patients were lower than those ofAECOPD.4. With the increasing of PSQI, the sleep latency, awake time after sleep onset and N1period were also increasing, however, the sleep efficiency, N2and N3periods weredecreasing.5. The patients’ frequency of AECOPD in six months were positively related withPSQI and negatively related with sleep efficiency.ConclusionThe sleep condition of AECOPD patients was much worse than the stable COPD,including the subjective and objective monitoring parameters. PSQI can objectivelyreflect the abnormal sleep condition of patients, which were similar to the results ofPSG, paralleled with CAT and mMRC. The patients’ frequency of AECOPD in sixmonth was related to total sleep time and sleep efficiency, and positively related toPSQI and CAT. Therefore, it may be advantageous to promote the sleep condition of patients if we control the exacerbation. Meanwhile, PSQI might be a way to assess theprognosis of COPD.