Does Sleep Increase COPD?

Good Sleep; Nine of Ten Don’t Get it

Poor sleep is associated with several illnesses. Does sleeping less increase the risk of life-threatening flare-ups in people with chronic obstructive pulmonary disease, or COPD? A new research shows that this happens.

The new study supported by National Institutes of Health, said that the risk for these flare-ups – sudden bouts of worsening breathing – was 25% to 95% higher in people who experienced poor sleep than in people who had good quality sleep.

The observational study, one of the largest to look at the links between sleep quality and COPD flare-ups, was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH.

COPD

COPD, a progressive, incurable lung condition that makes breathing difficult, affects more than 16 million adults in the United States and is a leading cause of death. COPD flare-ups, also known as exacerbations, can last for days and even weeks and are triggered by a variety of factors ranging from pollutants to cold and flu viruses, Poor sleep can weaken the immune system of a healthy person and make them more susceptible to colds and the flu; and this vulnerability can increase in people with COPD.

Although scientists have long known that people with COPD often experience sleep disturbances, the role of poor sleep as a trigger of COPD exacerbations has been understudied, with major research on this topic providing conflicting evidence. The current study fills an important knowledge gap, investigators say.

Among those who already have COPD, knowing how they sleep at night will tell me much more about their risk of a flare-up than knowing whether they smoked for 40 versus 60 years,” said lead study author Aaron Baugh, M.D., a clinical fellow at the University of California San Francisco Medical School and a practicing pulmonologist. That is very surprising and is not necessarily what I expected going into this study. Smoking is such a central process to COPD that I would have predicted it would be the more important predictor in the case of exacerbations.”

METHOD

For the study, the researchers followed 1,647 people with confirmed COPD who were enrolled in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS link is external), a multi-center U.S. longitudinal study funded by the NHLBI and the COPD Foundation and designed to evaluate COPD sub populations outcomes, and biomarkers. All the participants in this specific study were current or former tobacco smokers with a confirmed diagnosis of COPD, and they underwent at least one initial sleep evaluation upon enrolment. The researchers recorded COPD flare-ups over a three-year follow-up period and compared these measurements against the sleep quality of the participants. The researchers used a common tool for analyzing self-reported sleep quality – a combination of seven sleep measures, including sleep duration, timing of sleep, and frequency of disturbances.

They found that in general, poor sleep quality was strongly associated with a higher total of COPD flare-ups. Compared to those participants with the best possible sleep, those who were at the threshold or at the base level of poor sleep had a 25% increased chance of having a COPD flare-up with in the next year. Those with the worst sleep had a nearly 95% increased risk of having a COPD exacerbation within the next year.

“Our work provides a strong rationale in to paying more attention to sleep than we have in the past, from both a clinical and research perspective,” said Baugh.

Marishka Brown, Ph.D., director of the NHLBI’s National Center on Sleep Disorders Research, said, “This study adds to a growing knowledge base demonstrating the harmful effects of poor sleep on health in general but can be particularly damaging in people with devastating preexisting conditions, such as COPD.”

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