Abstract
Sleep disorders are common in patients with chronic obstructive pulmonary disease (COPD) and are associated with greater disease severity, more frequent exacerbations, greater use of emergency health care, and higher mortality. They may contribute to worsening of COPD course by reducing patients’ adherence to treatment. The aim of this study was to evaluate quality of sleep in COPD patients and to assess the relationship between impaired sleep and adherence to inhalation therapy. The study included 106 COPD patients who were asked to answer the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Adherence to Refills and Medications Scale (ARMS). Clinical and demographic data were also collected. We found that over 60% of patients presented with sleep disorders (PSQI ≥5) and 75% with daytime sleepiness. None of the patients presented with optimal adherence to pharmacotherapy. Worse adherence was correlated with greater sleep disorders (r = 0.56; p < 0.001). ARMS questionnaire proved to be of high overall internal consistency (Cronbach’s alpha = 0.85). In conclusion, poor quality of sleep coexists with poor adherence to treatment among COPD patients. ARMS was proved to be a reliable tool for the assessment of adherence. Interventions aimed at improving sleep quality may be helpful to improve adherence to inhalation therapy in COPD patients.
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References
Banks S, Van Dongen HP, Maislin G, Dinges DF (2010) Neurobehavioral dynamics following chronic sleep restriction: dose–response effects of one night for recovery. Sleep 33(8):1013–1026
Barnes PJ, Celli BR (2009) Systemic manifestations and comorbidities of COPD. Eur Respir J 33(5):1165–1185
Budhiraja R, Siddiqi TA, Quan SF (2015) Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med 11(3):259–270
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213
Drummond MB, Dasenbrook EC, Pitz MW, Murphy DJ, Fan E (2008) Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease: a systematic review and meta–analysis. JAMA 300(20):2407–2416
Fan VS, Giardino ND, Blough DK, Kaplan RM, Ramsey SD (2008) Costs of pulmonary rehabilitation and predictors of adherence in the National Emphysema Treatment Trial. COPD 5(2):105–116
Garrow AP, Yorke J, Khan N, Vestbo J, Singh D, Tyson S (2015) Systematic literature review of patient–reported outcome measures used in assessment and measurement of sleep disorders in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 10:293–307
GBD 2016 Causes of Death Collaborators (2017) Global, regional, and national age–sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390(10100):1151–1210
Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V (2013) Understanding patients’ adherence–related beliefs about medicines prescribed for long–term conditions: a meta–analytic review of the necessity–concerns framework. PLoS One 8(12):e80633
Jen R, Li Y, Owens RL, Malhotra A (2016) Sleep in chronic obstructive pulmonary disease: evidence gaps and challenges. Can Respir J 2016:7947198
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545
Johns MW (1992) Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 15(4):376–381
Klink M, Quan SF (1987) Prevalence of reported sleep disturbances in a general adult population and their relationship to obstructive airways diseases. Chest 91(4):540–546
Kripalani S, Risser J, Gatti ME, Jacobson TA (2009) Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low–literacy patients with chronic disease. Value Health 12(1):118–123
Mirza S, Clay RD, Koslow MA, Scanlon PD (2018) COPD guidelines: a review of the 2018 GOLD report. Mayo Clin Proc 93(10):1488–1502
Mollayeva T, Thurairajah P, Burton K, Mollayeva S, Shapiro CM, Colantonio A (2016) The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non–clinical samples: a systematic review and meta–analysis. Sleep Med Rev 25:52–73
Omachi TA, Blanc PD, Claman DM, Chen H, Yelin EH, Julian L, Katz PP (2012) Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. Sleep Med 13(5):476–483
Rand CS, Nides M, Cowles MK, Wise RA, Connett J (1995) Long–term metered–dose inhaler adherence in a clinical trial. The Lung Health Study Research Group. Am J Respir Crit Care Med 152(2):580–588
Restrepo RD, Alvarez MT, Wittnebel LD, Sorenson H, Wettstein R, Vines DL, Sikkema–Ortiz J, Gardner DD, Wilkins RL (2008) Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis 3(3):371–384
Shawon MS, Perret JL, Senaratna CV, Lodge C, Hamilton GS, Dharmage SC (2017) Current evidence on prevalence and clinical outcomes of co–morbid obstructive sleep apnea and chronic obstructive pulmonary disease: a systematic review. Sleep Med Rev 32:58–68
Somiah M, Taxin Z, Keating J, Mooney AM, Norman RG, Rapoport DM, Ayappa I (2012) Sleep quality, short–term and long–term CPAP adherence. J Clin Sleep Med 8(5):489–500
Turner J, Wright E, Mendella L, Anthonisen N (1995) Predictors of patient adherence to long–term home nebulizer therapy for COPD. The IPPB Study Group. Intermittent positive pressure breathing. Chest 108(2):394–400
Uchmanowicz I, Jankowska–Polanska B, Motowidlo U, Uchmanowicz B, Chabowski M (2016) Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD. Int J Chron Obstruct Pulmon Dis 11:963–970
Valipour A, Lavie P, Lothaller H, Mikulic I, Burghuber OC (2011) Sleep profile and symptoms of sleep disorders in patients with stable mild to moderate chronic obstructive pulmonary disease. Sleep Med 12(4):367–372
van Boven JF, Chavannes NH, van der Molen T, Rutten–van Molken MP, Postma MJ, Vegter S (2014) Clinical and economic impact of non–adherence in COPD: a systematic review. Respir Med 108(1):103–113
van Boven JF, Ryan D, Eakin MN, Canonica GW, Barot A, Foster JM (2016) Enhancing respiratory medication adherence: the role of health care professionals and cost–effectiveness considerations. J Allergy Clin Immunol Pract 4(5):835–846
Vardar–Yagli N, Saglam M, Savci S, Inal–Ince D, Calik–Kutukcu E, Arikan H, Coplu L (2015) Impact of sleep quality on functional capacity, peripheral muscle strength and quality of life in patients with chronic obstructive pulmonary disease. Expert Rev Respir Med 9(2):233–239
Vetrano DL, Bianchini E, Onder G, Cricelli I, Cricelli C, Bernabei R, Bettoncelli G, Lapi F (2017) Poor adherence to chronic obstructive pulmonary disease medications in primary care: role of age, disease burden and polypharmacy. Geriatr Gerontol Int 17(12):2500–2506
Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, Chen R, Decramer M, Fabbri LM, Frith P, Halpin DM, Lopez Varela MV, Nishimura M, Roche N, Rodriguez–Roisin R, Sin DD, Singh D, Stockley R, Vestbo J, Wedzicha JA, Agusti A (2017) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med 195(5):557–582
Conflicts of Interests
The authors declared no conflicts of interest in relation to this article.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the local Ethics Committee of Wroclaw Medical University in Poland.
Informed Consent
Written informed consent was obtained from all individual participants included in the study.
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Chabowski, M., Łuczak, J., Dudek, K., Jankowska-Polańska, B. (2019). Sleep Disorders and Adherence to Inhalation Therapy in Patients with Chronic Obstructive Pulmonary Disease. In: Pokorski, M. (eds) Advances in Pulmonary Medicine: Research and Innovations. Advances in Experimental Medicine and Biology(), vol 1160. Springer, Cham. https://doi.org/10.1007/5584_2019_345
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DOI: https://doi.org/10.1007/5584_2019_345
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