Study of Insomnia in Chronic Obstructive Pulmonary Disease Patients at a Tertiary Care Centre

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities caused by significant exposure to noxious particles or gases. Aims and Objectives: 1. To estimate the proportion of insomnia in Chronic Obstructive Pulmonary Diseases patients, 2. To study the association of insomnia with severity of Chronic Obstructive Pulmonary Diseases among study participants and 3. Assessment of Quality of Life among study participants. Materials and Methods: This prospective observational study was conducted in Department of Respiratory Medicine in a tertiary care center and medical college. Written informed consent was taken from all the study participants and those who give consent were enrolled in the present study. Total 159 COPD patients were included in the study, after satisfying the eligibility criteria. The COPD patients were enrolled after satisfying the eligibility criteria given GSAQ Questionnaire to find the presence of insomnia, PSQI for quality of sleep and then SF-36 score questionnaire to assess Quality of Life. Study was conducted for duration of 2 years (August 2018 to December 2020). Observation and Results: The most common age group amongst study population was 51 to 60 years (42%) followed by 40 to 50 years (29%) and more than 60 years (29%). There was male predominance (54.5%) in the study population as compared to females (45.5%). The most common occupation amongst study population was farmer (28%) followed by Shopkeeper (23%) and Driver (19%) and most of the study population were obese (65.2%) followed by normal BMI (28.8%) and underweight (6.1%). Most of the study population were Grade 2 dyspnea (36%) followed by Grade 3 (34%) and Grade 4 (16%). Most of the study population were Moderate COPD (45.5%) followed by severe COPD (27.3%) and very severe (21.2%). Comorbidities like Diabetes and Hypertension was observed in 11% and 28% of study population. 29% of study population was ex smokers. 69.57% of ex smokers had more than 20 pack years while 30.43% had less than 20 pack years. The prevalence of insomnia in our study population was 43%. The prevalence of insomnia was most commonly observed in severe COPD (40%) followed by Very severe COPD (35%), Moderate COPD (19%) and mild COPD (6%) and the difference was statistically significant. Mean Physical health score and Mental health score was significantly lower in insomnia patients as compared to non insomnia patients. Mean PSQI was significantly higher in insomniac patients as compared to non insomnia patients. Conclusion: 40% of our patients with COPD experienced poor sleep quality. Presence of insomnia in patients with COPD is also associated with increased day time sleepiness and worse QOL.