Targeted Interventions Could Improve Sleep Quality in Patients With Interstitial Lung Disease

While poor sleep quality is common in patients with interstitial lung disease (ILD), it is unclear which factors other than sleep disordered breathing may contribute to poor sleep quality for these patients. A study published in ERJ Open Research found that providers should target depression and coexisting sleep disorders in order to improve sleep quality and quality of life for patients with ILD.

The researchers assessed the prevalence of poor sleep quality in patients with ILD, identified independently associated factors, and examined the different symptomatology between good sleepers and poor sleepers.

“Most studies of sleep in patients with ILD have focused on polysomnographic abnormalities and nocturnal desaturation, but a greater understanding of psychological and patient-reported outcomes is required to identify factors associated with poor sleep quality to help guide future treatment and management,” the authors explained.

They studied 101 patients with ILD who were referred by respiratory physicians for pulmonary rehabilitation, and they assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The 19-item questionnaire consists of 7 components: sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleeping medications, and daytime dysfunction. Each item is scored between 0 and 3, resulting in a total PSQI score between 0 and 21. The higher the score, the worse the sleep quality.

Two-thirds (66%) of patients reported poor sleep quality based on their PSQI score. Patients with poor sleep quality had a higher score on the St George’s Respiratory Questionnaire, which assesses health-related quality of life, and higher Hospital Anxiety and Depression Scale scores for anxiety and depression.

They also found that the group with poor sleep quality had greater use of sleep medications and more daytime dysfunction. Responses to the sleep disturbance part of the PSQI revealed that patients with poor sleep quality reported more disruptions to sleep, such as “cannot breathe comfortably,” compared with the patients with good sleep.

“Studies looking at comparison of subjective sleep assessment with objective measurements of sleep in ILD patients with poor sleep quality are required to target other potential areas of sleep to improve overall quality of life in this population,” the authors concluded. “Intervention studies targeting depression and coexisting sleep disorders such as [obstructive sleep apnea] are required to determine if sleep quality and ultimately, health-related quality of life improve as a result.”

Reference

Cho J-G, Teoh A, Roberts M, Wheatley J. The prevalence of poor sleep quality and its associated factors in patients with interstitial lung disease: a cross-sectional analysis. ERJ Open Res. 2019;5:0062-2019. doi: 10.1183/23120541.00062-2019.