Dados do Trabalho

Título

ASSOCIATION BETWEEN SLEEP REGULARITY AND THE OCCURRENCE OF EXACERBATION IN INDIVIDUALS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.

Introdução

Chronic Obstructive Pulmonary Disease (COPD) is characterized by a progressive airflow obstruction, accompanied by limiting symptoms such as dyspnea and fatigue. The disease’s acute worsening is referred to as a period of disease exacerbation. This deterioration is linked to decline in various outcomes and increased mortality. Consequently, there is need to research and advance on these modifiable factors that could impact exacerbations. While sleep quality has been previously linked to the risk of exacerbation, the relationship between sleep regularity and potential association with episodes of exacerbation remains unknown.

Objetivo

To examine the relationship between the regularity of total sleep time (TTS), sleep efficiency (SE) and time wake after sleep onset (WASO) with outcomes concerning acute exacerbations in individuals with COPD.

Métodos

In this prospective cohort study, individuals with COPD underwent assessment of pulmonary function followed by objective sleep monitoring using Actiwatch. Sleep regularity was assessed by calculating the standard deviation of the variables. Telephone follow-ups were conducted at 3 and 6 months to gather information on exacerbations. Statistical analysis involved the Shapiro-Wilk test, point-biserial correlations or Kendall's Tau-B coefficient, and ROC curve analysis. The SPSS 20.0 software was adopted, and statistical significance was set as p<0.05.

Resultados

30 individuals diagnosed with COPD were analyzed (11 men; age 68±8 years; BMI 28±5 kg/m2; FEV1 59±19%pred). Significant correlations were observed between regularity in TTS and worsening of symptoms (r=0.41, p=0.026), use of antibiotics (r=-0.39, p=0.033), need for lung imaging tests (r=-0.46, p=0.020) and hospitalization (r=-0.37, p=0.050). Regularity in SE was correlated with the use of antibiotics (r=0.44, p=0.016), need for lung imaging tests (r=-0.51, p=0.010) and hospitalization (r=-0.41, p=0.028). Finally, regularity in WASO was correlated with increased bronchodilator use (r=-0.56, p=0.001). A cutoff point of 127 minutes for the TTS was identified concerning the worsening of symptoms (AUC: 0.776, p=0.029, sensitivity= 0.957 and specificity= 0.857).

Conclusões

Sleep regularity is moderately linked to the occurrence of acute exacerbations in individuals with COPD. Moreover, a threshold of 127 minutes of total sleep time appears suitable to identify worsening of symptoms in this group.

Palavras -chave

Chronic obstructive pulmonary disease; Sleep; Exacerbation.