Australian Regenerative Medicine Institute

The Relation of Sleep Complaints to Respiratory Symptoms in a General Population – Methods and Materials

The Relation of Sleep Complaints to Respiratory Symptoms in a General Population - Methods and MaterialsPatients with chronic airways obstructive disease (AOD) frequently have complaints of disturbed sleep. On polysomnography, sleep in patients with AOD is characterized by an increase in the number of arousals and a reduction in total sleep time. In a previous study using data from a large general population, we found that subjects with a diagnosis of asthma and chronic bronchitis, chronic bronchitis alone, or emphysema had a higher prevalence of sleep complaints than the rest of the sample population. It is unclear, however, if disturbed sleep in these subjects with AOD is related to severity of airways obstruction, an increase in potentially sleep-disruptive respiratory symptoms, or both. Therefore, we conducted a further analysis to define the relationship among sleep complaints, AOD diagnosis, and pulmonary function.

The design of the Tucson Epidemiologic Study of Obstructive Airways Disease (TESOAD) from which these data are derived has been reported in detail previously. Briefly, the study is a stratified random cluster sample of white, non-Hispanic households residing in Tucson, which have been surveyed prospectively at 1- to 2-year intervals starting in 1972. Details of the methods used in the surveys and in data compilation have been published previously, including the development of percent predicted values for spiro-metric variables.
Because we were interested in an adult population, we included only subjects who were at least 18 years of age at the time of the ninth survey and who had completed that survey’s questionnaire (2,109 subjects). Some subjects did not fill out their questionnaires completely, so slightly fewer subjects were included in some analyses. In addition, only 1,358 subjects who completed questionnaires performed satisfactory spirometry.
During the ninth survey (1984 to 1985), a series of questions concerning sleep were included in the self-administered questionnaire. Subjects were asked if they were troubled by any of the following sleep problems: (1) trouble falling asleep; (2) trouble staying asleep; (3) not enough sleep; (4) waking up too early and not being able to get back to sleep; and (5) falling asleep during the day. As described in our previous report, we combined responses to questions 1 to 4 so that subjects who answered “Yes, still have the problem” to any of these questions were classified as having a complaint of difficulty initiating or maintaining sleep (DIMS). Subjects who answered “Yes, still have the problem” to question 5 were classified as having a complaint of excessive daytime sleepiness (EDS).
Chronic AOD diagnoses were based on questionnaire responses during either the eighth (1984) or ninth survey. Subjects were considered to have asthma, for example, if they answered “Yes, I still have it” to the survey 8 question: “Have you ever had asthma?” Subjects who answered “Yes” to the ninth survey question “Since the last questionnaire, have you had or been treated for asthma?” were also considered to have asthma. Similar questions were asked about emphysema and chronic bronchitis. Based on their responses to these questions, subjects were then assigned to a diagnostic category: (1) asthma; (2) chronic bronchitis; (3) chronic bronchitis with asthma; (4) emphysema with or without asthma and/or chronic bronchitis; or (5) no respiratory disease. All categories were mutually exclusive and the same as we used in a previous report. For some analyses, we pooled the subjects with respiratory disease, labeling them as having AOD.

Category: Respiratory Symptoms

Tags: airways obstruction, asthma, chronic bronchitis, respiratory symptoms