Background Sleep disturbances are common in patients with chronic obstructive pulmonary disease (COPD) with a considerable negative impact on their quality of life. However, factors associated with measures of sleep in daily life have not been investigated before nor has the association between sleep and the ability to engage in physical activity on a day-to-day basis been studied.
Aims To provide insight into the relationship between actigraphic sleep measures and disease severity, exertional dyspnoea, gender and parts of the week; and to investigate the association between sleep measures and next day physical activity.
Methods Data were analysed from 932 patients with COPD (66% male, 66.4±8.3 years, FEV1% predicted=50.8±20.5). Participants had sleep and physical activity continuously monitored using a multisensor activity monitor for a median of 6 days. Linear mixed effects models were applied to investigate the factors associated with sleep impairment and the association between nocturnal sleep and patients' subsequent daytime physical activity.
Results Actigraphic estimates of sleep impairment were greater in patients with worse airflow limitation and worse exertional dyspnoea. Patients with better sleep measures (ie, non-fragmented sleep, sleeping bouts ≥225 min, sleep efficiency ≥91% and time spent awake after sleep onset <57 min) spent significantly more time in light (p<0.01) and moderate-to-vigorous physical activity (p<0.01).
Conclusions There is a relationship between measures of sleep in patients with COPD and the amount of activity they undertake during the waking day. Identifying groups with specific sleep characteristics may be useful information when designing physical activity-enhancing interventions.
- COPD Pathology
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Contributors GS, MAS, ACdB, conceived and designed the analysis. GS analysed the data and drafted the first version of the manuscript. MAS and ACdB. provided advice at all stages of the analysis. ACdB provided statistical support. MAS, JA, RPB, PMAC, CFC, RWC, DD-G, SD, JG-A, AJRvG, MG, NAH, KH, NSH, DJ, MK, AK, JDL, HM, FM WD-CM, ZJMcK, RM, DM, FP, SJS, FWJMS, RT-S, BV, BW, HW, EFMW and SZ. contributed to the acquisition of data in each centre included and/or participated in the critical revision of the manuscript. All authors accepted the final version of the manuscript.
Funding The Eindhoven-based authors and the CIRO-based authors gratefully acknowledge the financial support received by the iCare4COPD Project of Agentschap NL under Contract PNE101005. The Basel-based authors gratefully acknowledge the financial support received by the foundations ‘Gottfried und Julia Bangerter-Rhyner-Stiftung’, ‘Freiwillige Akademische Gesellschaft Basel’ and ‘Forschungsfonds der Universität Basel’.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The data collection was conducted in accordance with the declaration of Helsinki and approved by ethics committees at each of the participating centres, according to local regulations.
Provenance and peer review Not commissioned; externally peer reviewed.