title: Insomnia in patients with COPD.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be associated with sleep disturbances. However, the correlates of insomnia in COPD patients have not been well characterized. The aim of the current study was to describe the prevalence of insomnia disorder in COPD and to elucidate the demographic and clinical characteristics of COPD patients that are associated with insomnia.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Clinic-based sample from an academic hospital.
  
  
  METHODS
  Patients with stable COPD.
  
  
  METHODS
  An interviewer-conducted survey was administered to 183 participants with COPD. Seventy-two of these participants (30 with and 42 without insomnia) maintained a sleep diary and underwent actigraphy for 7 days.
  
  
  RESULTS
  Insomnia (chronic sleep disturbance associated with impaired daytime functioning) was present in 27.3% of participants. Current tobacco users (odds ratio (OR), 2.13) and those with frequent sadness/anxiety (OR, 3.57) had higher odds, but oxygen use was associated with lower odds (OR, 0.35) of insomnia. Patients with insomnia had worse quality of life and a higher prevalence of daytime sleepiness. Actigraphy revealed shorter sleep duration and lower sleep efficiency, and a sleep diary revealed worse self-reported sleep quality in participants with insomnia.
  
  
  CONCLUSIONS
  Insomnia disorder is highly prevalent in patients with COPD; current tobacco use and sadness/anxiety are associated with a higher prevalence, and oxygen use with a lower prevalence of insomnia; patients with insomnia have poorer quality of life and increased daytime sleepiness; and insomnia is associated with worse objective sleep quality.
authors.affiliation: Department of Medicine, Southern Arizona Veterans Affairs Health Care System (SAVAHCS), Tucson, AZ 85723, USA. rohit.budhiraja@va.gov
authors.forename: Rohit
authors.initials: R
authors.lastname: Budhiraja
authors.forename: Sairam
authors.initials: S
authors.lastname: Parthasarathy
authors.forename: Pooja
authors.initials: P
authors.lastname: Budhiraja
authors.forename: Michael P
authors.initials: MP
authors.lastname: Habib
authors.forename: Christopher
authors.initials: C
authors.lastname: Wendel
authors.forename: Stuart F
authors.initials: SF
authors.lastname: Quan
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology