PURPOSE: To Study the prevalence of insomnia in geriatric COPD patients in pulmonary rehabilitation program.
METHODS: A population study was performed via questionnaire that was administered to volunteers diagnosed with COPD with a FEY1 less than 60% older than 60 years in pulmonary rehabilitation and gave the informed consent sleep questionnaire, Beck's Anxiety Inventory, Beck's Depression Inventory, Mini Mental Status Examination (MMSE) were administered to assess the level of anxiety, depression and mental status of patients. Epworth Sleepiness Scale was administered to objectively correlate and assess the validity of excessive daytime tiredness.
RESULTS: 50 patients of 102 (HUMC Pulmonary Rehabilitation during the year 2007) met the criteria and were enrolled. Fev1 ranged from 18%–60%. 34% of the patients self reported a total sleep time less than 6 hours; 24% reported poor sleep quality, 56% reported excessive daytime sleepiness, 24% reported difficultly initating sleep, 40% reported difficulty maintaining sleep and 12% reported the diagnosis of insomnia. 28% reported memory problems. 60% contributed their sleep disturbances to anxiety and 40 % to depression with 48% contributed difficulty initiating sleep only to anxiety. The average ESS was 7. 26% reported snoring, 24% reported witnessed apneas episodes as per bed partner, and 18% reported sleep evaluation including polysmonagraphy diagnosing sleep apnea syndrome. 44% reported >2–3 awakenings per night and 40% used oxygen. 24 % had a BMI30%. 2% reported RLS.
CONCLUSION: COPD patients should be screened repeatedly for symptoms for sleep disorders and referred for sleep evaluation and for evaluation of anxiety and depression levels, especially those enrolled in pulmonary rehabilitation programs. Treatment of Anxiety in patients in Pulmonary Rehabilitation might treat difficulty initiating and maintaining sleep in this subset of geriatric population. The referring physicians and the rehabilitation program providers can easily incorporate general sleep screening questions as part of the initial evaluation.
CLINICAL IMPLICATIONS: The prevalence of difficulty initiating and maintaining sleep (DIMS) in geriatric COPD population is significant. Further emphasis on screening the COPD patients for Anxiety and DIMS is warranted.
DISCLOSURE: Sue Zafarlotfi, No Financial Disclosure Information; No Product/Research Disclosure Information