Sleep Problems Are Tied to a Risk of Life-Threatening COPD Flare-Ups

Insufficient or interrupted sleep may have a bigger impact on COPD symptoms than smoking, a study has found.

Fact-Checked
Female doctor using stethoscope on a senior patient
COPD patients should make solving sleep problems a priority, researchers say.Aja Koska/iStock

Poor sleep is associated with an increased risk of potentially life-threatening disease flare-ups in patients with chronic obstructive pulmonary disorder (COPD), according to a new study.

People with COPD have lung conditions that block airflow and make it harder to breathe. There are two main types of COPDemphysema and chronic bronchitis — and many people experience both, per the National Heart, Lung, and Blood Institute (NHLBI).

Researchers did sleep assessments for 1,647 patients with COPD and then followed them over three years to see how often they had flare-ups that required treatment.

Compared with people who slept well, those with mild sleep problems were 25 percent more likely to have COPD flare-ups, according to the study's results, reported June 6 in the journal Sleep. Patients with the most severely insufficient or interrupted sleep were almost twice as likely to experience disease flare-ups.

Over time, these exacerbations of symptoms like shortness of breath and cough can cause irreversible lung damage, worsening COPD and increasing the chance that the disease will progress to the point where it proves fatal, the study team noted.

But sleep is often overlooked by physicians when they're evaluating patients with COPD, said the senior study author,?Neeta Thakur, MD, a pulmonologist at the University of California San Francisco (UCSF) School of Medicine, in a statement.

“Sleep hygiene and sleep aids may significantly improve their health,” Dr. Thakur said. “Sleep should be considered both in the clinic and at the wider community/neighborhood level, where the structural factors that contribute to worse sleep can be addressed.”

Study participants were 65 years old on average and had moderately severe COPD at the start of the study. They were all current or former smokers.

More than half of them were male, and the majority were white, but about 14 percent of the participants were African American.

For people with the most severe sleep problems, the increased risk of COPD flare-ups was comparable to that of someone with a 60-year history of smoking instead of a 40-year history of smoking, said the lead study author,?Aaron Baugh, MD, of the UCSF Cardiovascular Research Institute.

Poor sleep was much more common among African Americans in the study, impacting 63 percent of them compared with 52 percent of white patients. The study results suggest this sleep discrepancy may be one reason why African Americans may have a worse prognosis with COPD than white patients, Dr. Baugh said.

“African Americans are overrepresented in low-income neighborhoods, where people are less likely to have good quality sleep,” Baugh said. “They may live in crowded spaces with multiple roommates, and have less comfortable sleeping conditions, such as a couch, and they may work in a job with a varying schedule that lends itself to sleep disruption.”

While the study wasn’t a controlled experiment designed to prove whether or how sleep might directly influence COPD outcomes, Bough said that it’s possible that sleep deprivation might cause a decline in infection-fighting antibodies and proteins known as cytokines that signal the immune system to kick into action.

The U.S. Centers for Disease Control and Prevention (CDC) recommends the following tips for good sleep hygiene, or healthy habits that can help you get enough high-quality rest:

  • Be consistent. Go to bed at the same time each night and get up at the same time each morning, including on the weekends.
  • Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature.
  • Remove electronic devices, such as TVs, computers, and smartphones, from the bedroom.
  • Avoid large meals, caffeine, and alcohol before bedtime.
  • Get some exercise. Physical activity during the day can help you fall asleep more easily at night.