Identification and clinical characteristics of sleep phenotypes in patients with chronic obstructive pulmonary disease
Abstract. Sleep disorder is one of the common complaints of patients with chronic obstructive pulmonary disease (COPD). Sleep in patients with COPD can be accompanied by desaturation, which subjectively and objectively worsens its quality.Ponomareva I.B., Glotov S.I., Uryasyev O.M., Belskikh E.S.
The aim: to identify and characterize sleep phenotypes in patients with COPD.
Material and methods. 60 male individuals (mean age 65.6 ± 8.3 years) with COPD outside of exacerbation were included in the study. All patients completed CAT (COPD Assessment Test) questionnaire to assess the severity of COPD symptoms, modified Medical Research Council Dyspnea Scale (mMRC) in points to determine the intensity of dyspnea, HADS (Hospital Anxiety and Depression Scale), Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index (PSQI). In addition, spirometry and nocturnal monitoring pulse oximetry by a portable oximeter with a finger sensor were performed. Patients who reported a history of snoring and/or who had a sawtooth pattern of the saturation curve according to the results of night monitoring pulse oximetry were referred to an in-depth sleep study followed by a consultation with somnologist.
Results. According to the results of the studies, patients with COPD were divided into three sleep phenotypes: COPD + obstructive sleep apnea syndrome (OSAS) (n = 7); COPD with nocturnal desaturation (n = 25); COPD without nocturnal desaturation (n = 28). COPD + OSAS phenotype, comparatively with the other two, was characterized by a significantly higher body mass index, greater sleepiness according to the Epworth scale, and more pronounced COPD symptoms according to CAT. Phenotypes with and without nocturnal desaturation did not have significant differences in forced expiratory volume in 1 second and body mass index, but daytime and minimum saturation values differed significantly. In terms of sleep quality according to the PSQI, no significant differences were obtained between the different phenotypes.
Conclusion. Identification and characterization of sleep phenotypes in COPD facilitates their early detection and personalized approach to treatment.
Keywords
sleep phenotypes in chronic obstructive pulmonary disease
nocturnal desaturation
obstructive sleep apnea syndrome
syndrome of combination of chronic obstructive pulmonary disease and obstructive sleep apnea syndrome
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About the Authors
Irina B. Ponomareva, MD, PhD (Medicine), associate professor, associate professor of the Department of faculty therapy named after Professor V.Ya. Garmash, Academician I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of Russia. Address: 390000, Ryazan, 3A Internatsionalnaya St.E-mail: docib@yandex.ru
ORCID: https://orcid.org/0000-0002-0273-4388. Scopus ID: 57201763814. eLibrary SPIN: 3984-1944
Sergey I. Glotov, MD, PhD (Medicine), associate professor, associate professor of the Department of faculty therapy named after professor V.Ya. Garmash, Academician I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of Russia. Address: 390000, Ryazan, 3A Internatsionalnaya St.
E-mail: sergeyglot@mail.ru
ORCID: https://orcid.org/0000-0002-4445-4480. Scopus ID: 57203780371. eLibrary SPIN: 7524-9816
Oleg M. Uryasyev, MD, Dr. Sci (Medicine), professor, head of the Department of faculty therapy named after professor V.Ya. Garmash, Academician I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of Russia. Address: 390000, Ryazan, 3A Internatsionalnaya St.
E-mail: uryasev08@yandex.ru
ORCID: https://orcid.org/0000-0001-8693-4696. Scopus ID: 57195313767. eLibrary SPIN: 7903-4609
Eduard S. Belskikh, MD, PhD (Medicine), associate professor, associate professor of the Department of faculty therapy named after professor V.Ya. Garmash, Academician I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of Russia. Address: 390000, Ryazan, 3A Internatsionalnaya St.
E-mail: ed.bels@yandex.ru
ORCID: https://orcid.org/0000-0003-1803-0542. Scopus ID: 57195313786. eLibrary SPIN: 9350-9360
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