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Original Research: SLEEP MEDICINE |

Sleep Quality and Health-Related Quality of Life in Idiopathic Pulmonary Fibrosis

Vidya Krishnan, MD, MHS, FCCP; Meredith C. McCormack, MD, MHS; Stephen C. Mathai, MD, MHS; Shikhar Agarwal, MD; Brittany Richardson; Maureen R. Horton, MD, FCCP; Albert J. Polito, MD, FCCP; Nancy A. Collop, MD; Sonye K. Danoff, MD, PhD
Author and Funding Information

*From MetroHealth Medical Center (Dr. Krishnan), Cleveland, OH; Johns Hopkins University School of Medicine (Drs. McCormack, Mathai, Horton, Collop, and Danoff), Baltimore, MD; Johns Hopkins Bloomberg School of Public Health (Dr. Agarwal), Baltimore, MD; University of Maryland Baltimore County (Ms. Richardson), Baltimore, MD; and Mercy Medical Center (Dr. Polito), Baltimore, MD.

Correspondence to: Sonye K. Danoff, MD, PhD, Johns Hopkins University School of Medicine, 1830 E Monument St, 5th Floor, Baltimore, MD 21205; e-mail: sdanoff@jhmi.edu

†Drs. Krishnan and McCormack contributed equally to the manuscript.


This work was supported by a grant from the CHEST Foundation.

The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(4):693-698. doi:10.1378/chest.08-0173
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Background:  Idiopathic pulmonary fibrosis (IPF) is a progressive disorder resulting in irreversible scarring of the lung parenchyma. Although fatigue is a prominent symptom for patients with IPF, little is known about sleep quality in patients with IPF.

Methods:  In this cross-sectional study of 41 patients with IPF from a prospectively designed cohort, we ascertained sleep quality by means of the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale. Health status, baseline demographics, and physiologic parameters were also assessed.

Results:  Patients with IPF reported extremely poor sleep quality and high frequency of daytime sleepiness, which differs significantly from normal control populations. Further, poor sleep quality was not associated with body mass index, age, gender, or lung function. This population also demonstrated extremely poor health status in a number of domains, including physical function and vitality. Poor sleep quality (by the global PSQI) was significantly associated with decreased quality of life (QOL) in several domains, including role of physical function (r = − 0.58, p = 0.001), vitality (r = − 0.43, p = 0.015), and role of emotions (r = − 0.40, p = 0.023).

Conclusions:  Poor sleep quality is extremely common in patients with IPF and is not predicted by variables traditionally associated with sleep-disordered breathing. Further, poor sleep quality is associated with poor QOL. These findings suggest that systematic evaluation of the cause of poor sleep quality in IPF is merited.


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