Prevalence and impact of insomnia in patients with chronic obstructive pulmonary disease

ObjectivesTo determine the prevalence of insomnia in patients with chronic obstructive pulmonary disease (COPD) and evaluate its association with health status, pulmonary function, anxiety/depression, and exacerbations.MethodsA cross-sectional observational study was conducted including consecutive COPD outpatients. Data collected included sociodemographic and clinical variables, daytime sleepiness (Epworth Sleepiness Scale), quality of life (COPD Assessment Test, CAT), anxiety and depression (HADS), insomnia severity (Insomnia Severity Index, ISI), and exacerbations in the previous year. Multivariable logistic regression analysis was performed to identify independent predictors of insomnia.ResultsA total of 103 patients (77 males, 26 females) were included. Insomnia prevalence was 38.8% (32.5% mild, 55.0% moderate, 12.5% severe). No significant differences in pulmonary function were observed between patients with and without insomnia. However, patients with insomnia had poorer health status (CAT 19.13±8.63 vs. 11.32±8.13; p<0.001), greater daytime sleepiness (Epworth 5.23±3.10 vs. 3.84±2.31; p<0.011), higher anxiety prevalence (61.5% vs. 31.2%; OR=3.533), and more exacerbations (50% vs. 28.6%; OR=2.5; p<0.037). In multivariable analysis, the CAT score was the only independent predictor of insomnia (OR 1.083; 95% CI 1.011-1.160; p = 0.023).ConclusionsInsomnia is highly prevalent in COPD and is associated with poorer health status, greater daytime sleepiness, increased anxiety, and more frequent exacerbations. Poorer health status was the only independent predictor of insomnia.