The Relation of Sleep Complaints to Respiratory Symptoms in a General Population – Discussion
Table 4 demonstrates the importance of the various independent variables in the regression model. Wheezing apart from colds independently increased the risk of DIMS as did age, obesity, and female gender. Moreover, neither a diagnosis of AOD (or the individual disease categories) nor severity of airways obstruction was predictive of DIMS. Similarly, cough or sputum production, age, and male gender increased the risk of EDS while a diagnosis of lung disease and airways obstruction did not.
To maximize the number of subjects included in the above logistic regression analyses, we did not include snoring as an independent variable because many of the subjects did not know if they snored (768). Separate analyses of the 1,222 subjects who had values for all the above independent variables and snoring revealed that snoring was a significant risk factor for EDS (odds ratio = 1.48; 95 percent confidence intervals [Cl] = 1.13 to 1.94) but not for DIMS.
Several authors have found that patients with chronic obstructive lung disease have more sleep complaints than controls. Kinsman and his coworkers reported that sleep difficulties ranked third after dyspnea and fatigue in their 146 patients attending pulmonary clinics. Nearly one half of the patients had sleep difficulties “always” or “almost always.” Cormick and his coworkers2 studied 50 patients with chronic obstructive pulmonary disease (COPD) and found that 36 percent of the patients had difficulty falling asleep and 76 percent reported more than two awakenings each night. Seventy-two percent reported daytime sleepiness. Among a subgroup of 16 patients studied with polysomnography, the investigators found that the patients averaged 15 arousals per hour. They also reported a relation between lower oxygen saturation and arousals. buy antibiotics online
In this study, we have also found that persons with respiratory disease complain of sleeping poorly. In the present analyses, however, both DIMS and EDS complaints were related to the presence of respiratory symptoms more strongly than to a diagnosis of lung disease or the degree of airways obstruction. In addition, as shown in Table 1, the more symptoms a subject had, the higher the rate of sleep complaints.
Thus, while it is well documented that subjects or patients with pulmonary disease sleep poorly, investigators differ in their explanations of this phenomenon. As mentioned above, Cormick et al2 suggested that oxygen desaturation, a common occurrence in patients with pulmonary disease, might be the reason their patients slept poorly. In support of that view, Goldstein and coworkers reported that oxygen improved sleep in their patients with COPD. Fleetham and coworkers, however, in a study of 24 patients, found that the decreased sleep time and increased arousals seen in their patients were not improved by treatment with sufficient oxygen to eliminate desahiration below 90 percent.
Table 4—Multiple Logistic Regression Analysis of Risk Factors for Sleep Complaints
|DIMS Risk Factor||OddsRatio||95% Cl||EDS Risk Factor||OddsRatio||95% Cl|
Category: Respiratory Symptoms
Tags: airways obstruction, asthma, chronic bronchitis, respiratory symptoms