ABS61: A Qualitative study of sleep experiences in subjects with moderate to severe Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Introduction:

Sleep disturbances are common in COPD and poor sleep reduces quality of life, causing fatigue, a prominent symptom associated with anxiety, depression and inactivity. Research into patients’ attitudes and beliefs about sleep experiences can identify the most relevant issues and the need for intervention.

Aims:

To investigate sleep experiences in COPD, in order to (a) design a survey of sleep problems and (b) determine the need for simple interventions (e.g. sleep hygiene education).

Subjects and methods:

Ten subjects (six female) with moderate to severe COPD were recruited by a community specialist nurse. Transcriptions of semi-structured interviews were analysed by mapping key concepts and extracting emergent themes. Questionnaires describing sleep and symptom characteristics: Chronic Respiratory Disease Questionnaire (CRDQ), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS).

Results:

All subjects were studied. Mean FEV1 predicted 31.8% (+7.7). PSQI: Eight subjects had poor sleep quality, six had severe problems with sleep latency, five with sleep duration and habitual sleep efficiency; four with subjective sleep quality. Five subjects had some daytime sleepiness (ESS score>6); four subjects had problems with anxiety and/or depression (HADS). Chronically fragmented sleep patterns were attributed to symptoms (e.g. sputum) and other problems (e.g. noise). Most subjects acknowledged a relationship between good sleep and psychological and physical well being, although few had sought advice on sleep. Some had made lifestyle adjustments. Emergent topics included reduced activity, sleep disturbances, sleep position, not tired, napping, boredom, frustration, medication, and Sleep hygiene. Several suggested a reduced need for sleep due to lack of physical activity and/or tiredness.

Conclusions:

Lack of sleep causes significant concern for many patients with COPD, and some suffer from a lack of professional support. Patient-orientated research can identify needs and direct access to simple interventions.

Conflict of interest and funding

Funding: Respiratory Research Unit. Conflicts of interest: None.