Analyzing Characteristics Associated with Symptomatic Sleep Disturbance in COPD Patients

分析COPD患者症狀性睡眠障礙相關之病人特徵

蔡尚峯(Shan-Fon Tsai) ； 許淑美(Shew-Meei Sheu) ； 蔡青芳(Ching-Fang Tsai) ； 林明憲(Ming-Shian Lin) ； 陳煒(Wei Chen) ； 陳弈仁(Yi-Jen Chen)

《胸腔醫學》 34卷4期 (2019/08) Pp. 139-147

摘要

Introduction: Sleep disturbance, characterized by difficulty of falling asleep, interrupted sleep, and feeling unrefreshed upon waking, may compromise a patient's quality of life and survival rate. Cough and shortness of breath are the most frequent symptoms in chronic obstructive pulmonary disease (COPD) patients. However, symptomatic sleep disturbance is not clearly defined. Our study aimed to identify characteristics that correlate with symptomatic sleep disturbance in COPD patients in Taiwan. Methods: This was a cross-sectional study conducted between 2011 and 2012. We successfully recruited 180 COPD patients over 40 years of age. Each participant had to fill out a questionnaire to determine whether they had symptomatic sleep disruption due to cough and difficulty breathing. Analysis parameters included the participants' demographics, acute exacerbation (AE), comorbidities, COPD Assessment Test (CAT) scores, and lung function test results. Results: The mean age and body mass index of all patients were 71.7 years and 22.8 kg/m^2, respectively. The prevalence of symptomatic sleep disturbances among the COPD patients was 28.9% (52/180). Those with symptomatic sleep disturbances also had significantly higher CAT scores (15.9 ± 10.5 vs. 9.5 ± 7.0, p ＜ 0.01) and AE occurrence (52.0% vs. 29.8%, p ＜ 0.05) than those without sleep disturbances. Multivariable analysis revealed that the CAT score (odds ratio, 1.1, 95% confidence interval, 1.1-1.2) was an independent factor significantly associated with symptomatic sleep disturbance. Conclusions: Symptomatic sleep disturbances occurred in 28.9% of COPD patients. The CAT score was correlated with self-reported symptomatic sleep disturbances in COPD patients and can be used as a predictor for symptomatic sleep disturbance.

關鍵字

chronic obstructive pulmonary disease (COPD) ； sleep disturbance ； COPD assessment test (CAT)

並列摘要

前言：睡眠障礙的特點是入睡困難，睡眠中斷，醒來後感覺不清醒可能會影響患者其生活品質及存活率。咳嗽和呼吸急促是慢性肺阻塞患者最常見之症狀，而症狀性睡眠障礙未被明確定義。此研究在於探討台灣COPD患者之症狀性睡眠障礙相關之病人特徵。方法：此為2011－2012年間進行之橫斷面研究，成功招募180名40歲以上之慢性肺阻塞患者，其皆填寫是否因咳嗽或呼吸困難而產生睡眠障礙之問卷。分析參數包括參與者之人口學變項、急性發作次數、合併症、慢性肺阻塞評估量表（CAT）與肺功能。結果：患者之平均年齡和身體質量指數（BMI）分別為71.7歲和22.8公斤／平方公尺。症狀性睡眠障礙之罹患率為28.9%。症狀性睡眠障礙患者之CAT分數與急性發作率顯著高於無症狀性睡眠障礙患者（p＜0.05）。多變量分析顯示CAT分數為與症狀性睡眠障礙具顯著性相關之獨立因子（OR，1.1；95%信賴區間，1.1-1.2）。結論：COPD患者之症狀性睡眠障礙罹患率為28.9%，CAT評分與COPD患者自我報告的症狀性睡眠障礙相關，可作為症狀性睡眠障礙的預測因子。

並列關鍵字

慢性肺阻塞（COPD） ； 睡眠障礙 ； 慢性肺阻塞評估量表（CAT）