Nocturnal breathing symptoms chronic pulmonary obstruction A survey of patients and physicians revealed that COPD significantly impairs daily activities and health-related quality of life.
Most of the patients surveyed (74%) reported experiencing nocturnal symptoms, while physicians stated that they prescribed treatments based on 24-hour symptom relief to most of their patients (78%).
The researchers recommended that healthcare professionals explore individualized treatments to achieve maximum 24-hour symptom relief.
Survey results are detailed in the study,”The burden of nocturnal symptoms in patients with chronic obstructive pulmonary disease: results of a real-world survey in the United States of AmericaAnd thePublished in the magazine Pulmonary therapy.
People with COPD often report poor sleep quality and worse breathing symptoms At night. Nocturnal symptoms may also occur along with sleep disturbances, such as obstructive sleep apnea and low blood oxygen levels during the night. Despite these reports, current COPD treatment guidelines rarely mention nocturnal symptoms and sleep disturbances.
The study, conducted and sponsored by GSK, sought to understand the importance of nocturnal symptoms in COPD patients and to assess the importance of controlling them compared to daytime symptoms.
The team collected data from the Adelphi Respiratory Disease Program, a survey of US physicians and their patients. The survey was completed by 800 adults with COPD and 171 physicians including 92 primary care physicians and 79 pulmonologists who cared for three or more COPD patients per month.
Timing and frequency of COPD symptoms
Data on nocturnal symptoms were available for 690 patients, of whom 33 (4.8%) reported having nocturnal symptoms every day. These patients were, on average, older compared to patients without nocturnal symptoms and were less engaged in full-time jobs.
The frequency of nocturnal symptoms is comparable between those with different body mass indexes (BMI), a measure of body fat content, and between males and females.
Compared to nocturnal symptoms, diurnal symptoms were reported more frequently. Overall, 12% reported only daytime symptoms, 34% reported mainly daytime symptoms, 43% said their symptoms occurred equally during the day and night, 10% experienced predominantly nocturnal symptoms, and 2% experienced nighttime symptoms. Just.
Of the 74% who reported nocturnal symptoms, 7% had nocturnal symptoms every night. Most (88%) had diurnal symptoms, and 14% reported that they occur every other day.
A higher proportion of those with nocturnal symptoms each day had comorbidities, or concurrent health conditions, including high blood pressure (76%), anxiety (36%), depression (24%), anemia, or low levels of Red blood cells (21%), and gastro-intestinal reflux disease (33%).
Impact of nocturnal symptoms on quality of life
Sleep disturbance was assessed by the Jenkins Sleep Assessment Questionnaire (JSEQ), which measures the frequency of sleep disturbances, with lower scores indicating less disturbance. Average JSEQ scores increased with a higher frequency of nocturnal symptoms, ranging from 3.2 in those who had no symptoms at night to 9.5 in those who had symptoms every night.
Among patients who completed the Work Productivity and Activity Impairment (WPAI) questionnaire, those with symptoms each night showed the greatest impairment in activity. Nothing was working. Their activity was affected by 66.9% versus 41.1% in patients with less frequent nocturnal symptoms and 26.4% in patients without nighttime symptoms.
Nightly symptoms were also associated with lower quality of life, as assessed by the EuroQoL 5-level 3-level (EQ-5D-3L) questionnaire. Participants with nocturnal symptoms each night had an average EQ-5D-3L score of 0.602 compared to 0.882 in those without them.
Doctors’ reports indicated that COPD affected many aspects of a patient’s life, including getting up and getting ready for the day, relationships, leisure activities, sleep, and work. COPD affected sleep occasionally, frequently, or consistently in 37% of patients.
Reasons why doctors choose treatment
Most patients (76%) took maintenance medication daily, which is the same among patients who report nocturnal symptoms every night. Doctors said controlling nighttime symptoms was the reason they chose treatment for 38% of their patients, and relief during the day for 61%.
Clinicians cited improvement in nocturnal symptoms as the reason for choosing treatment in patients receiving once-daily maintenance therapy versus twice-daily treatment (40 versus 42%).
“Daytime and nighttime symptoms are common among COPD patients,” the researchers wrote. Frequency of nocturnal symptoms was associated with significant impairment in activity and health [quality of life]. “
“As a first step to reduce sleep complaints and increase sleep quality among COPD patients, healthcare professionals should improve COPD treatment as recommended in current guidelines,” the researchers wrote. “Great 24″[hour] Symptom control is likely to reduce daytime and nighttime symptoms in COPD patients.”