A new NIH study suggests that poor sleep is associated with 25% to 95% higher risks of exacerbations in patients with chronic obstructive pulmonary disease (COPD). The study findings are published in the journal Sleep.¹

For the present study, researchers enrolled 1647 patients with COPD from the multicenter Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). The participants were either current or former smokers and had their diagnosis confirmed by spirometry. The Pittsburgh Sleep Quality Index (PSQI) was used to measure quality of sleep, which included duration of sleep, timing of sleep and frequency of disturbances. The participants were followed for three years to investigate if sleep quality and COPD exacerbations were linked. The impact of socio-environmental exposures was also examined using the Area Deprivation Index (a composite measure of neighborhood quality) and Adversity-Opportunity Index (a composite measure of individual-level historic and current socioeconomic indicators).

Results showed that overall, the risk of COPD exacerbation within the next year was 25% higher in patients who reported poor sleep quality, whereas the risk was 95% higher in those with the worst sleep quality. The risk of disease flare-up increased by 5% for a rise in PSQI score for every point. On exploratory analysis, the effect was less in patients residing in poor-quality neighborhoods.

 “Sleep is healing”. There is growing evidence supporting the beneficial effect of sleep on immunity. Good quality sleep enhances immunity. This observational study adds to the harmful effects of poor sleep on the health of an individual. particularly in those who have an underlying condition. It has shown that compared to those with good sleep quality, COPD patients with poor sleep quality were at higher risk of experiencing more frequent exacerbations of their disease. By reducing the immunity, poor sleep may predispose these patients to the risk of infections, which may trigger acute disease flare-ups. All COPD patients should be asked about sleep quality and referred for appropriate intervention if required. Based on these findings, “poor sleep may be a better predictor of flare-ups than even a person’s history of smoking”.² 

References

1. Baugh A, et al. Risk of COPD exacerbation is increased by poor sleep quality and modified by social adversity. Sleep. 2022 Jun 6;zsac107. doi: 10.1093/sleep/zsac107.
2. National Institutes of Health. June 6, 2022. Accessed June 8, 2022. Available at: https://www.nih.gov/news-events/news-releases/nih-supported-study-links-poor-sleep-increased-risk-copd-flare-ups