PURPOSE: Sleep quality is impaired in IPF (1). We speculate insomnia may contribute to this impairment.
METHODS: We measured subjective insomnia severity in an IPF population using the Insomnia Severity Index (ISI), a validated instrument for surveying insomnia (2,3). IPF Subjects completed the ISI during a support group meeting in Charleston, SC, in an IRB approved protocol. Scores >8 identify “sub-threshold” insomnia; scores >14 identify those with moderate clinically significant insomnia; scores >18 indicate severe, clinically significant insomnia (2,3). Data was gathered from 52 subjects; 94% (n=49) completed the instrument.
RESULTS: 78% (n=38/49) reported scores >8 indicating abnormal sleep. The mean (SD) ISI score for the entire group was 12.0 (7.0) with a median score of 13.0 indicative of “sub-threshold insomnia”. Among the 41% of the sample reporting moderate to severe clinically significant insomnia, (ISI>14), the mean ISI score was 19.0(4.0), with a median of 17.0. These ISI scores, when compared to published normative data (2,3) for insomnia patients with substance abuse, painful syndromes or primary insomnia (mean ISI 15.4) show that IPF subjects self-report significantly higher severities of insomnia (p < 0.01).
CONCLUSION: Self-reported insomnia in IPF is common and often severe. When above “sub-threshold” values, insomnia in IPF patients is more severe than in those with insomnia due to pain, substance abuse, or primary insomnia.
CLINICAL IMPLICATIONS: Sleep evaluations should be extended to the IPF patient routinely. IPF, a chronic and progressive disease, often leads to comorbid depression and fatigue, accounting for some insomnia, but primary disorders of sleep should be excluded as modifiable contributors. Research efforts to determine factors contributing to insomnia in IPF need further evaluation. These data need to be replicated in larger, more representative, samples. 1.Ahmed QA . Sleep Quality in Patients with Idiopathic Pulmonary Fibrosis (IPF) Is Poor. AJRCCM 2007,175; A568 2.Morin CM. Insomnia: psychological assessment and management. New York: Guilford Press 1993 3.Bastein CH et al. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2000;2:297-307.
DISCLOSURE: Qanta Ahmed, No Financial Disclosure Information; No Product/Research Disclosure Information