Examining sleep quality and mortality risks in COPD, asthma, and asthma-COPD overlap patients

Chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and asthma-COPD overlap (ACO), contribute to significant health burdens. Understanding patient characteristics, sleep patterns, and mortality factors is critical for improving management.

Data from the UK Biobank were used to compare the baseline characteristics, sleep patterns, and mortality rates of 14,326 COPD, asthma, and ACO patients. Multivariable logistic and linear regression analyses were conducted to identify factors affecting mortality and sleep.

COPD patients were older, with higher smoking rates and mortality compared to ACO and asthma patients (P < 0.001). Asthma patients had the highest BMI (29.76), while ACO patients showed the highest diabetes prevalence (14.2%) and asthma patients had the highest hypertension prevalence (46.9%) (P < 0.001). Asthma patients exhibited the poorest sleep quality, with higher rates of short sleep duration, insomnia, and daytime dozing compared to COPD and ACO patients (P < 0.001). Multivariable analysis revealed that COPD patients had higher mortality risks compared to ACO patients (P < 0.001), and poor sleep scores and diabetes were significantly associated with increased mortality (P < 0.001). Asthma patients had significantly lower sleep scores than ACO patients (P < 0.001).

ACO patients showed intermediate outcomes, with worse sleep than asthma patients but better than COPD patients. Poor sleep quality, along with diabetes and smoking, was linked to higher mortality. Addressing sleep disturbances may reduce mortality in ACO and COPD patients, warranting further research on targeted interventions.