Diagnostic Role of Global Sleep Assessment Questionnaire in Stable Chronic Obstructive Pulmonary Disease Patients

  • Sunil Kumar Assistant professor, Department of Chest and TB, Pacific Medical college and hospital Udaipur (Rajasthan)
  • Manish Advani Assistant professor, Department of Chest and TB, Pacific Medical college and hospital Udaipur (Rajasthan)
  • Jyoti Kumari Assistant professor, Department of Chest and TB, Pacific Medical college and hospital Udaipur (Rajasthan)
Keywords: Global sleep assessment questionnaire, COPD, Sleep disorders

Abstract

Background:There is a complex interaction among COPD symptoms, sleep problems, ongoing medicines and other comorbidities in COPD patients so it is noteworthy whether the GSAQ may be used in COPD patients in the same way as in general population. We did a study on stable COPD patients with the aim to investigate the utility of GSAQ in stable COPD patients. We also investigated various sleep disorders in stable COPD patients and their relationship with patient’s demographics, smoking status and diseases severity.

Methods: This prospective observational study was carried out on clinically stable COPD patients.  A Hindi translation of GSAQ was self-administered by each patient. The sensitivity and specificity of GSAQ in COPD patients were calculated, using diseases defining criteria as the gold standard.  The sleep disorders ware also compared to patient demographics, smoking status and diseases severity.

Results: The sensitivity and specificity of GSAQ in identifying insomnia, RLS, daytime sleepiness and anxiety-depression were 91/95%, 91.7/90%, 70.5/79.2% and 81.1/96.5% respectively. In this study the prevalence of sleep disorders was 56.4%. The commonest sleep problem was insomnia (35%) followed by RLS (31%), parasomnia (18%) and sleep apnoea (11.7%). These were no significant difference between GSAQ positive and negative group in patient’s demographics, smoking status and diseases severity. The COPD patients with insomnia had significantly lower FEV1 as compared to those without insomnia.

Conclusion: GSAQ may be used in COPD patients for both screenings and to rule out core intrinsic sleep disorders and depression- anxiety. Sleep disorders are frequent problems in stable COPD patients and insomnia is the most common among them.

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References

1. Roth T, Zammit G, Kushida C, Doghramji K, Mathias SD, Wong JM et al. A new questionnaire to detect sleep disorders. Sleep Med 2002;3:99-108.
2. Klingman KJ, JungquistCR , Perlis ML. Questionnaires that screen for multiple sleep disorders. Sleep Medicine Reviews 2017;32:37-44.
3. Nunes DM, Mota RM, de Pontes Neto OL, Pereira ED, de Bruin VM, de Bruin PF. Impaired sleep reduces quality of life in chronic obstructive pulmonary disease. Lung 2009;187:159-63.
4. Fleetham J, West P, Mezon B, Conway W, Roth T, Kryger M. Sleep, arousals, and oxygen desaturation in chronic obstructive pulmonary disease. The effect of oxygen therapy. Am Rev Respir Dis 1982;126:429-33.
5. Budhiraja R, Parthasarathy S, Budhiraja P, Habib MP, Wendel C, Quan SF. Insomnia in patients with COPD. Sleep 2012;35:369-75.
6. Omachi TA, Blanc PD, Claman DM, Chen H, Yelin EH, Julian L et al. Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. Sleep Med 2012;13:476-83.
7. Klink M, Quan SF. Prevalence of reported sleep disturbances in a general adult population and their relationship to obstructive airways diseases. Chest 1987;91:540-6.
8. Klink ME, Dodge R, Quan SF. The relation of sleep complaints to respiratory symptoms in a general population. Chest 1994;105:151-4.
9. Jones PW, Harding G, Berry P, Wiklund I, Chen WH, KlineLeidy N. Development and first validation of the COPD assessment test. Eur Respir J 2009;34:648-54.
10. Fletcher CM. Standardised questionnaire on respiratory symptoms: a statement prepared and approved by MRC committee on the aetiology of chronic bronchitis (MRC breathlessness score). BMJ 1960;2:1665.
11. Brian L. Graham, Irene Steenbruggen, Martin R. Miller, Igor Z. Barjaktarevic, Brendan G. Cooper, Graham L. Hall et al. Standardization of Spirometry 2019 Update:An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 2019;200:e70-e88.
12. Global initiative for the diagnosis, management and prevention of chronic obstructive pulmonary disease. Updated 2020. Available from: https://goldcopd.org/gold-reports/
13. Murray W. Johns. A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale. Sleep 1991;14:540-5. https://doi.org/10.1093/sleep/14.6.540.
14. Michael J Sateia. International Classification of Sleep Disorders-Third Edition. Chest 2014;146:1387-94.
15. Richard P. Allen, Daniel L. Picchietti, Diego Garcia-Borreguero, William G. Ondo, Arthur S. Walters, John W. Winkelman et al. Restless legs syndrome/Willis–Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria – history, rationale, description, and significance. Sleep Medicine 2014;15:860-73.
16. Kroenke, Kurt & Spitzer, Robert & Williams, Janet &Löwe, Bernd. An Ultra-Brief Screening Scale for Anxiety and Depression: The PHQ–4. Psychosomatics 2009;50:613-21.
17. Sameer Vaidya, Ram B Sah, AnchalTeotiya, Dipti Gothi. Evaluation of Sleep Disorders in Chronic Obstructive Pulmonary Disease Patients by Subjective Questionnaire and Their Correlation with FEV1, PaO2, and PaCO2. Indian journal of sleep Medicine 2017;12:60-3.
18. Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med 2015;11:259-70.
19. Schneider C, Jick SS, Bothner U, Meier CR. COPD and the risk of depression. Chest 2010;137:341-7.
20. Atlantis E, Fahey P, Belinda Cochrane B, Smith S. Bidirectional associations between clinically relevant depression or anxiety and chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis. Chest 2013;144:766-77.
21. Winkelman JW, Redline S, Baldwin CM, Resnick HE, Newman AB, Gottlieb DJ. Polysomnographic and health-related quality of life correlates of restless legs syndrome in the Sleep Heart Health Study. Sleep 2009;32:772-8.
22. Willgoss TG, Yohannes AM. Anxiety disorders in patients with COPD: a systematic review. Respir Care 2013;58:858-66.
23. Cormick W, Olson LG, Hensley MJ, Saunders NA. Nocturnal hypoxaemia and quality of sleep in patients with chronic obstructive lung disease. Thorax 1986;41:846-54.
24. Valipour A, Lavie P, Lothaller H, Mikulic I, Burghuber OC. Sleep profile and symptoms of sleep disorders in patients with stable mild to moderate chronic obstructive pulmonary disease. Sleep Med 2011;12:367-72.
25. Price D, Small M, Milligan G, Higgins V, Gil EG, Estruch J. The prevalence and impact of nighttime symptoms in COPD patients—a real-world study in five European countries. Int J Chron Obstruct Pulmon Dis 2013;8:595-603.
26. Yuksel Kaplan, Handan Inonu, Ayse Yilmaz, Serpil Ocal. Restless Legs Syndrome in Patients with Chronic Obstructive Pulmonary Disease. Can. J. Neurol. Sci. 2008;35:352-7.
27. Budhiraja R, Roth T, Hudgel DW, Budhiraja P, Drake CL. Prevalence and polysomnographic correlates of insomnia comorbid with medical disorders. Sleep 2011;34:859-67.
28. Ohayon M. Epidemiological study on insomnia in the general population. Sleep 1996;19:S7-S15.
29. Lee HB, Hening WA, Allen RP, et al. Restless legs syndrome is associated with DSM-IV major depressive disorder and panic disorder in the community. J Neuropsychiatry Clin Neurosci2008;20:101-5.
30. Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med 2015;11:259-70.
31. Lo Coco D, Mattaliano A, Lo Coco A, Randisi B. Increased frequency of restless legs syndrome in chronic obstructive pulmonary disease patients. Sleep Med 2009;10:572-6.
Published
2021-03-30
How to Cite
1.
Kumar S, Advani M, Kumari J. Diagnostic Role of Global Sleep Assessment Questionnaire in Stable Chronic Obstructive Pulmonary Disease Patients . Int Arch BioMed Clin Res [Internet]. 2021Mar.30 [cited 2021May9];7(1):PM1-PM5. Available from: https://iabcr.org/index.php/iabcr/article/view/691
Section
ORIGINAL ARTICLES ~ Pulmonary Medicine