Poor Sleep Quality Could Exacerbate COPD

By Jonathan Springston, Editor, Relias Media

People with poor sleep quality were more likely to experience COPD flare-ups than similar patients who sleep well, according to the recently published results of an observational study.

Backed by the National Heart, Lung, and Blood Institute, investigators examined the data of more than 1,600 people who were enrolled in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). All subjects were former or current smokers, had been diagnosed with COPD, and had undergone at least one sleep evaluation. Over three years, the researchers monitored COPD flare-ups and sleep quality (i.e., sleep disturbances, frequency of disturbances, sleep timing, sleep duration).

Generally, participants at the threshold of poor sleep quality were 25% more likely to experience a COPD flare-up within the next year. Those with the worst sleep quality were 95% more likely.

“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 vs. 60 years,” said lead study author Aaron Baugh, MD, 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.”

COPD, a chronic, incurable condition, affects more than 16 million Americans. Flare-ups can last for days or even weeks, can require hospitalization, and can lead to death. Poor sleep is known to weaken the immune system, making these patients more vulnerable to flu and other infections, which can, in turn, exacerbate COPD. Baugh and colleagues noted Black patients especially report poor sleep quality and struggle with COPD more than others.

“Our work provides a strong rationale into paying more attention to sleep than we have in the past, from both a clinical and research perspective,” Baugh said. “While we now know that sleep quality can predict future exacerbations, we don't know whether improving sleep quality will yield direct improvements in COPD outcomes. We encourage future studies that can look at the impact of interventions, whether at the individual or community level.”