Silent Nights, Restless Lungs: Sleep Quality and Associated Factors Among COPD Patients in Vietnam - A...

Nocturnal symptoms and sleep disturbances are increasingly recognized as clinically important in chronic obstructive pulmonary disease (COPD) but remain understudied in low- and middle-income countries. The objective of this study was to assess sleep quality and determine its association with respiratory symptoms in Vietnamese outpatient COPD patients.

We conducted a cross-sectional study on 289 consecutive patients (≥ 40 years old) with a confirmed COPD diagnosis who were being monitored at the COPD management unit of Bach Mai Hospital, Hanoi (February2025 to May 2025). Demographic and clinical data (modified Medical Research Council [mMRC] dyspnea scale, COPD Assessment Test [CAT] score, forced expiratory volume in 1 second [FEV₁] after bronchodilator use, comorbidities, and number of hospitalizations in the previous year) were collected through structured interviews and medical record reviews. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI).

The mean PSQI total score was 9.2 ± 3.7; 85.8% of participants met the threshold for poor sleep. A total of 65.4% of patients had an mMRC grade ≥ 2, 88.9% had a CAT score ≥ 10, and 88.9% of patients had an acute hospitalization in the past year. A high CAT score, a high mMRC grade, long disease duration, and FEV₁ below 50% were risk factors for impaired sleep quality as measured by the PSQI.

Poor sleep quality is highly prevalent among Vietnamese outpatient COPD patients and is closely associated with respiratory symptom burden and disease severity. These findings underscore the importance of routine sleep quality assessment in COPD management and suggest that optimizing symptom control may contribute to improved sleep and overall patient outcomes.