Identification and clinical characteristics of sleep phenotypes in patients with chronic obstructive pulmonary disease

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Аннотация

Sleep disorder is one of the common complaints of patients with chronic obstructive pulmonary disease (COPD). Sleep in patients with COPD can be accompanied by desaturation, which subjectively and objectively worsens its quality.

The aim: to identify and characterize sleep phenotypes in patients with COPD.

Material and methods. 60 male individuals (mean age 65.6 ± 8.3 years) with COPD outside of exacerbation were included in the study. All patients completed CAT (COPD Assessment Test) questionnaire to assess the severity of COPD symptoms, modified Medical Research Council Dyspnea Scale (mMRC) in points to determine the intensity of dyspnea, HADS (Hospital Anxiety and Depression Scale), Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index (PSQI). In addition, spirometry and nocturnal monitoring pulse oximetry by a portable oximeter with a finger sensor were performed. Patients who reported a history of snoring and/or who had a sawtooth pattern of the saturation curve according to the results of night monitoring pulse oximetry were referred to an in-depth sleep study followed by a consultation with somnologist.

Results. According to the results of the studies, patients with COPD were divided into three sleep phenotypes: COPD + obstructive sleep apnea syndrome (OSAS) (n = 7); COPD with nocturnal desaturation (n = 25); COPD without nocturnal desaturation (n = 28). COPD + OSAS phenotype, comparatively with the other two, was characterized by a significantly higher body mass index, greater sleepiness according to the Epworth scale, and more pronounced COPD symptoms according to CAT. Phenotypes with and without nocturnal desaturation did not have significant differences in forced expiratory volume in 1 second and body mass index, but daytime and minimum saturation values differed significantly. In terms of sleep quality according to the PSQI, no significant differences were obtained between the different phenotypes.

Conclusion. Identification and characterization of sleep phenotypes in COPD facilitates their early detection and personalized approach to treatment.

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Авторлар туралы

Irina Ponomareva

Academician Pavlov Ryazan State Medical University

Хат алмасуға жауапты Автор.
Email: docib@yandex.ru
ORCID iD: 0000-0002-0273-4388
SPIN-код: 3984-1944
Scopus Author ID: 57201763814

MD, PhD (Medicine), Associate Professor of the Professor Garmash Department of Faculty Therapy

Ресей, 3A, Internatsionalnaya St., Ryazan, 390000

Sergey Glotov

Academician Pavlov Ryazan State Medical University

Email: sergeyglot@mail.ru
ORCID iD: 0000-0002-4445-4480
SPIN-код: 7524-9816
Scopus Author ID: 57203780371

MD, PhD (Medicine), Associate Professor of the Professor Garmash Department of Faculty Therapy

Ресей, 3A, Internatsionalnaya St., Ryazan, 390000

Oleg Uryasyev

Academician Pavlov Ryazan State Medical University

Email: uryasev08@yandex.ru
ORCID iD: 0000-0001-8693-4696
SPIN-код: 7903-4609
Scopus Author ID: 57195313767

MD, Dr. Sci (Medicine), Professor, Head of the Professor Garmash Department of Faculty Therapy

Ресей, 3A, Internatsionalnaya St., Ryazan, 390000

Eduard Belskikh

Academician Pavlov Ryazan State Medical University

Email: ed.bels@yandex.ru
ORCID iD: 0000-0003-1803-0542
SPIN-код: 9350-9360
Scopus Author ID: 57195313786

MD, PhD (Medicine), Associate Professor of the Professor Garmash Department of Faculty Therapy

Ресей, 3A, Internatsionalnaya St., Ryazan, 390000

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2. Fig. Saturation patterns during different sleep phenotypes in patients with chronic obstructive pulmonary disease (COPD): A - COPD without nocturnal desaturation; B - COPD with nocturnal desaturation; C - crossover syndrome (COPD + obstructive sleep apnoea syndrome)

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