Investigating the risk factors for the coexistence of insomnia and its exacerbation in AECOPD

Abstract

Aim

Explore the risk factors contributing to insomnia and its severity in patients experiencing Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).

Methods

The study included 155 patients with AECOPD from Chaohu Hospital, Anhui Medical University, treated between September 2022 and October 2023. Patients were categorized into insomnia groups (mild, moderate, severe) and a comparison group based on Insomnia Severity Index Scale (ISI) scores. Sleep quality and severity were assessed using the Pittsburgh Sleep Quality Index (PSQI), CAT score, and mMRC classification. Clinical data, pathology, and results from various laboratory tests were collected. Details of current admission treatment, including ventilator usage, medication types, and administration methods, were documented for group comparisons.

Results

This study included 155 AECOPD patients, with over 70 % identified as high-risk for obstructive sleep apnea (OSA). Among them, 87 were in the insomnia group and 68 in the comparison group. The insomnia group comprised 46 mild, 36 moderate, and 5 severe cases. Female patients, those with lower education, shorter smoking history, higher CAT and PSQI scores, more frequent hospital admissions, and those using oral or intravenous glucocorticoids were more likely to experience insomnia. In the moderate insomnia subgroup, patients had higher CAT and PSQI scores and longer hospitalization than the mild insomnia group. No significant differences were found in the use of quinolones, glucocorticoid administration, ventilator use, or resuscitation behaviors among insomnia severity levels.

Conclusion

Insomnia coexisting with AECOPD is prevalent, with the patient's gender, educational level, smoking history, severity of clinical symptoms, and the type of treatment influencing their sleep status.