Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes.
Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes.
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DOI：
10.1016/j.sleep.2011.12.007
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发表时间：
2012-05
期刊：
影响因子：
4.8
通讯作者：
Katz, Patricia P.
中科院分区：
文献类型：
--
作者：
Omachi, Theodore A.;Blanc, Paul D.;Claman, David M.;Chen, Hubert;Yelin, Edward H.;Julian, Laura;Katz, Patricia P.
关键词：
研究COPD严重程度与睡眠障碍之间的横断面关联，以及睡眠障碍与不良健康结局之间的纵向关联。通过基于人群的随机数字电话拨号招募了98名经肺活量测定确诊的成年COPD患者。睡眠障碍的评估采用四项失眠症状评定量表，包括：入睡困难、夜间觉醒、早晨疲倦和睡眠时间充分性。COPD严重程度通过以下指标进行量化：FEV1和COPD严重程度评分，包括COPD症状、对COPD药物和氧气的需求以及医院使用情况。在基线后一年对受试者进行评估，以确定COPD的纵向恶化和紧急利用情况，并对其进行中位数2.4年的跟踪，以评估全因死亡率。睡眠障碍与咳嗽、呼吸困难和COPD严重程度评分有关，但与FEV1无关。在控制社会人口学和体重指数的多变量Logistic回归分析中，睡眠障碍纵向预测慢性阻塞性肺疾病的发病(OR=4.7p=0.018)和与呼吸相关的急救使用(OR=11.5p=0.004)。在COX比例风险分析中，控制相同的协变量，睡眠障碍预示较差的生存(HR=5.0P=0.013)。对于所有结果，在控制了基线FEV1和COPD严重程度评分后，这些关系持续存在。睡眠障碍与更严重的COPD有关，并纵向预测COPD的恶化、紧急医疗保健的利用和死亡率。
To investigate the cross-sectional association between COPD severity and disturbed sleep and the longitudinal association between disturbed sleep and poor health outcomes. 98 adults with spirometrically-confirmed COPD were recruited through population-based, random-digit telephone dialing. Sleep disturbance was evaluated using a 4-item scale assessing insomnia symptoms as: difficulty falling asleep, nocturnal awakening, morning tiredness, and sleep duration adequacy. COPD severity was quantified by: FEV1 and COPD Severity Score, which incorporates COPD symptoms, requirement for COPD medications and oxygen, and hospital-based utilization. Subjects were assessed one year after baseline to determine longitudinal COPD exacerbations and emergency utilization and were followed for a median 2.4 years to assess all-cause mortality. Sleep disturbance was cross-sectionally associated with cough, dyspnea, and COPD Severity Score but not FEV1. In multivariable logistic regression, controlling for sociodemographics and body-mass index, sleep disturbance longitudinally predicted both incident COPD exacerbations (OR=4.7; p=0.018) and respiratory-related emergency utilization (OR=11.5; p=0.004). In Cox proportional hazards analysis, controlling for the same covariates, sleep disturbance predicted poorer survival (HR=5.0; p=0.013). For all outcomes, these relationships persisted after also controlling for baseline FEV1 and COPD Severity Score. Disturbed sleep is cross-sectionally associated with worse COPD and is longitudinally predictive of COPD exacerbations, emergency health care utilization, and mortality.
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影响因子：
4.8
作者：
Killgore, William D. S.;Kahn-Greene, Ellen T.;Balkin, Thomas J.
通讯作者：
Balkin, Thomas J.
影响因子：
120.7
作者：
FORD, DE;KAMEROW, DB
通讯作者：
KAMEROW, DB
影响因子：
4.9
作者：
Blanc, PD;Eisner, MD;Balmes, JR
通讯作者：
Balmes, JR
DOI：
10.1164/ajrccm.152.3.7663792
发表时间：
1995-09-01
影响因子：
24.7
作者：
通讯作者：
--
影响因子：
5.6
作者：
Bellia, V;Catalano, F;Rengo, F
通讯作者：
Rengo, F