title: Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity.
abstract: Sleep disturbances are common in patients with chronic obstructive pulmonary disease (COPD) with a considerable negative impact on their quality of life. However, factors associated with measures of sleep in daily life have not been investigated before nor has the association between sleep and the ability to engage in physical activity on a day-to-day basis been studied.
  
  
  
  To provide insight into the relationship between actigraphic sleep measures and disease severity, exertional dyspnoea, gender and parts of the week; and to investigate the association between sleep measures and next day physical activity.
  
  
  
  Data were analysed from 932 patients with COPD (66% male, 66.4±8.3 years, FEV1% predicted=50.8±20.5). Participants had sleep and physical activity continuously monitored using a multisensor activity monitor for a median of 6 days. Linear mixed effects models were applied to investigate the factors associated with sleep impairment and the association between nocturnal sleep and patients' subsequent daytime physical activity.
  
  
  
  Actigraphic estimates of sleep impairment were greater in patients with worse airflow limitation and worse exertional dyspnoea. Patients with better sleep measures (ie, non-fragmented sleep, sleeping bouts ≥225 min, sleep efficiency ≥91% and time spent awake after sleep onset <57 min) spent significantly more time in light (p<0.01) and moderate-to-vigorous physical activity (p<0.01).
  
  
  
  There is a relationship between measures of sleep in patients with COPD and the amount of activity they undertake during the waking day. Identifying groups with specific sleep characteristics may be useful information when designing physical activity-enhancing interventions.
authors.affiliation: Department of Signal Processing Systems, Technische Universiteit Eindhoven, Eindhoven, The Netherlands.|Data Science Group, Philips Research, Eindhoven, The Netherlands.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Spina
authors.affiliation: Department of Research and Education, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.|REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.|Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Spruit
authors.affiliation: Clinical and Rehabilitation Sciences, The University of Sydney, Sydney, New South Wales, Australia.|Physiotherapy Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Alison
authors.affiliation: Mindful Breathing Laboratory, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Roberto P
authors.initials: RP
authors.lastname: Benzo
authors.affiliation: School of Ageing and Chronic Disease, University Hospital Aintree, Liverpool, UK.
authors.forename: Peter M A
authors.initials: PMA
authors.lastname: Calverley
authors.affiliation: Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Clarenbach
authors.affiliation: Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Costello
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Donaire-Gonzalez
authors.affiliation: Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland.
authors.forename: Selina
authors.initials: S
authors.lastname: Dürr
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Garcia-Aymerich
authors.affiliation: Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Arnoldus J R
authors.initials: AJR
authors.lastname: van Gestel
authors.affiliation: Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Gramm
authors.affiliation: Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil.
authors.forename: Nidia A
authors.initials: NA
authors.lastname: Hernandes
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Washington, Australia.
authors.forename: Kylie
authors.initials: K
authors.lastname: Hill
authors.affiliation: NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, UK.
authors.forename: Nicholas S
authors.identifier: 0000-0003-3235-0454
authors.initials: NS
authors.lastname: Hopkinson
authors.affiliation: AstraZeneca, Barcelona, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Jarreta
authors.affiliation: Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
authors.affiliation: Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kirsten
authors.affiliation: Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland.
authors.forename: Jörg D
authors.initials: JD
authors.lastname: Leuppi
authors.affiliation: Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany.
authors.forename: Helgo
authors.initials: H
authors.lastname: Magnussen
authors.affiliation: Centre de recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, 2725 Chemin Ste-Foy Québec, Université Laval, Québec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Maltais
authors.affiliation: NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, UK.
authors.forename: William D-C
authors.initials: WD
authors.lastname: Man
authors.affiliation: Clinical and Rehabilitation Sciences, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Zoe J
authors.initials: ZJ
authors.lastname: McKeough
authors.affiliation: Department of Research and Education, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.|Department of Respiratory Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands.
authors.forename: Rafael
authors.initials: R
authors.lastname: Mesquita
authors.affiliation: Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Miedinger
authors.affiliation: Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pitta
authors.affiliation: Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Singh
authors.affiliation: Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Frank W J M
authors.initials: FWJM
authors.lastname: Smeenk
authors.affiliation: GSK R&D, King of Prussia, Pennsylvania, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Tal-Singer
authors.affiliation: Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Vagaggini
authors.affiliation: Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany.
authors.forename: Benjamin
authors.identifier: 0000-0002-1070-3661
authors.initials: B
authors.lastname: Waschki
authors.affiliation: Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Centre for Lung Research, Grosshansdorf, Germany.
authors.forename: Henrik
authors.initials: H
authors.lastname: Watz
authors.affiliation: Department of Research and Education, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.|Department of Respiratory Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands.
authors.forename: Emiel F M
authors.initials: EFM
authors.lastname: Wouters
authors.affiliation: Medical University Clinic, Cantonal Hospital Baselland, Liestal and Medical Faculty, University of Basel, Basel, Switzerland.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Zogg
authors.affiliation: Data Science Group, Philips Research, Eindhoven, The Netherlands.
authors.forename: Albertus C
authors.initials: AC
authors.lastname: den Brinker
mesh_terms: D056044:Actigraphy / Q000379:methods*; D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology*; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D013997:Time Factors
keywords: COPD Pathology; Exercise