The Relation of Sleep Complaints to Respiratory Symptoms in a General Population – Conclusion
Moreover, when Calverley and coworkers studied 20 patients with COPD, they found that the “pink puffers,” patients with satisfactory oxygen saturations both while awake and when asleep, had more disturbed sleep than the “blue bloaters,” patients with marked oxygen desaturation, especially during sleep.
Because the TESOAD is an epidemiologic survey, we cannot discount the possibility that oxygen desaturation contributed to the disturbed sleep our subjects reported. Nevertheless, other investigators also have reported that symptoms rather than objective measurements of severity of disease correlated with poor sleep. Montplaisir and his associates studied asthmatic patients both while symptomatic with recurrent attacks of wheezing and later after their conditions were improved. These investigators demonstrated that sleep efficiency improved and awake time after sleep onset decreased after their patients symptoms were well controlled. In another study that found a relation between symptoms and poor sleep, Stokes and co-workers demonstrated that three of nine young patients with cystic fibrosis had coughing spells associated with sleep disorganization and concluded that symptoms play a role in the disturbed sleep of patients with pulmonary disease. buy flovent inhaler
In our analyses, respiratory symptoms were more predictive of sleep disturbances than either specific diagnoses of respiratory diseases or level of pulmonary function. It is important to note that our study population as well as methodology were much different than that of the investigators mentioned above. We had a large number of subjects and, unlike the small groups of patients studied by others, our subjects had a wide variety of diagnostic labels. Among the 462 subjects with cough or sputum, for example, 273 (59.1 percent) had no current or past diagnosis of airways disease. Conversely, of the 415 subjects with a diagnosis of airways disease, only 45.5 percent (189) complained of cough or sputum. Thus, among the Tucson subjects, respiratory symptoms and diagnostic labels were not closely correlated.
In addition, sleep complaints in our population did not relate to level of pulmonary function. Other investigators have also found that sleep complaints are common among patients with pulmonary disease regardless of their functional impairment.2 Because there are so many influences on rates of sleep complaints (anxiety, sleeping conditions, use of caffeine and other drugs), it is not surprising that we did not detect a consistent effect of level of pulmonary function.
Previous studies have established that patients with other chronic medical illnesses, such as arthritis or chronic renal disease, have more difficulty initiating or maintaining sleep than healthy people. Based on the above results, it is possible that sleep complaints might correlate better with symptoms that occur commonly in such patients, such as night pain or nocturia, rather than with diagnoses.
In summary, we have found that specific respiratory symptoms, mainly cough or sputum production and wheezing apart from colds, are more predictive of sleep complaints among subjects of a general population than either lung function or a diagnosis of lung diseases.
Category: Respiratory Symptoms
Tags: airways obstruction, asthma, chronic bronchitis, respiratory symptoms