title: Sleep in patients with large pleural effusion: impact of thoracentesis.
abstract: OBJECTIVE
  This study aimed to evaluate the sleep quality and impact of thoracentesis on sleep in patients with a large pleural effusion.
  
  
  METHODS
  Patients with large unilateral pleural effusion were evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire and dyspnea Borg scale. Full polysomnography (PSG) was performed on the night before and 36 h after thoracentesis.
  
  
  RESULTS
  We studied 19 patients, 11 males and 8 females, age 55 ± 18 years and body mass index of 26 ± 5 kg/m(2). The baseline sleep quality was poor (PSQI = 9.1 ± 3.5). Thoracentesis removed 1.624 ± 796 mL of pleural fluid and resulted in a significant decrease in dyspnea Borg scale (2.3 ± 2.1 vs. 0.8 ± 0.9, p < 0.001). The PSG before and after thoracentesis showed no significant change in apnea-hypopnea index and sleep time with oxygen saturation <90%. There was a significant improvement in sleep efficiency (76% vs. 81%, p = 0.006), decrease percent sleep stage 1 (16% vs. 14%, p = 0.002), and a trend improvement in total sleep time (344 ± 92 vs. 380 ± 69 min, p = 0.056) and percentage of rapid eye movement sleep (15% vs. 20%, p = 0.053). No significant changes occurred in six patients that performed two consecutive PSG before thoracentesis. The improvement in sleep quality was not associated with the volume of pleural fluid withdrawn or changes in dyspnea.
  
  
  CONCLUSIONS
  Patients with large pleural effusion have poor subjective and objective sleep quality that improves after thoracentesis.
authors.affiliation: Sleep Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo, Av. Doutor Altino Arantes, 648, apt 163, Vila Clemetino, São Paulo, SP, Brazil, CEP 04042-003. biancafm_@hotmail.com
authors.forename: Bianca Fernandes
authors.initials: BF
authors.lastname: Marcondes
authors.forename: Francisco
authors.initials: F
authors.lastname: Vargas
authors.forename: Fabio Henrique
authors.initials: FH
authors.lastname: Paschoal
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Cartaxo
authors.forename: Lisete R
authors.initials: LR
authors.lastname: Teixeira
authors.forename: Eduardo Henrique
authors.initials: EH
authors.lastname: Genofre
authors.forename: Roberto
authors.initials: R
authors.lastname: Onishi
authors.forename: Robert
authors.initials: R
authors.lastname: Skomro
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
mesh_terms: D000328:Adult; D000368:Aged; D015505:Chest Tubes; D004322:Drainage; D004417:Dyspnea / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010996:Pleural Effusion / Q000503:physiopathology* / Q000628:therapy*; D017286:Polysomnography; D012123:Pulmonary Ventilation / Q000502:physiology; D012894:Sleep Stages; D016896:Treatment Outcome
chemical_list: D010100:Oxygen