title: Variability of respiratory symptoms in severe COPD.
abstract: BACKGROUND
  While it is known that asthma symptoms have a very variable pattern, the general belief is that the respiratory symptoms in COPD patients usually present little or no variability. Nevertheless, COPD patients report having "bad days". The objective of this present study was to evaluate the variability of the respiratory symptoms and their impact on the daily activities of a cohort of Spanish COPD patients.
  
  
  METHODS
  We present the results of the Spanish patients who participated in a cross-sectional epidemiological study carried out in 17 European countries. Pulmonologists and Family Care physicians recruited patients with stable severe COPD (FEV1<50%). The perception of the patients on the variation in their symptoms was recorded by telephone interviews.
  
  
  RESULTS
  A total of 472 patients provided data that was valid for analysis. Mean age was 68.6; 93% were men; mean FEV1(%) was 41%. 84.1% of the patients experimented at least one respiratory symptom in the previous week and 60.9% affirmed that their symptoms varied over the course of the day or week. The moment of the day when the symptoms were perceived to be more intense was during the morning.
  
  
  CONCLUSIONS
  An important proportion of severe COPD patients perceive variability in their respiratory symptoms, with a greater intensity in the morning. The observation can have implications in treating patients with severe COPD as variability can be an initial sign of decompensation of the disease.
authors.affiliation: Servicio de Neumología, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Espinosa de los Monteros
authors.forename: Carolina
authors.initials: C
authors.lastname: Peña
authors.forename: Enrique Javier
authors.initials: EJ
authors.lastname: Soto Hurtado
authors.forename: Javier
authors.initials: J
authors.lastname: Jareño
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
mesh_terms: D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015331:Cohort Studies; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy; D011788:Quality of Life; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D020919:Sleep Disorders, Intrinsic / Q000453:epidemiology / Q000209:etiology; D013030:Spain / Q000453:epidemiology; D013689:Telephone
chemical_list: D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists