Sleep phenotypes and clinical outcomes in individuals with chronic obstructive pulmonary disease: A cohort study

In COPD, most studies have examined sleep characteristics in isolation, and limited evidence exists regarding sleep phenotypes and their impact on clinical outcomes. To prospectively investigate the impact of sleep phenotypes on several relevant clinical outcomes in individuals with COPD. Based on sleep nighttime assessed at baseline by both objective and subjective methods, individuals were classified into different sleep phenotypes: ‘short sleep’ and ‘high propensity to sleep + average sleep’. Furthermore, in a prospective cohort, individuals were assessed at baseline and after 12 months for lung function, body composition, peripheral muscle strength, functional capacity, daily physical activity (PA) and symptoms of dyspnea, anxiety, and depression. Twenty-nine individuals with COPD were analyzed. In both subjective and objective assessments, the ‘short sleep’ phenotype showed worsening in more outcomes when compared to the other phenotype, with significant worsening in FEV1 (p = 0.038), dyspnea (p = 0.020), light-intensity PA as % of the day (p = 0.028), sedentary time as % of the day (p = 0.028) and peripheral muscle strength (p = 0.003). Repeated-measures ANOVA showed a significant main effect of time for light PA and sedentary time, with large effect sizes. There was no significant interaction between time and subjective sleep phenotypes, although sedentary time showed a borderline result. Individuals with COPD who present the ‘short sleep’ phenotype show significant worsening in lung function, daily PA and peripheral muscle strength over 12 months. Furthermore, the interaction between sleep duration and phenotype may influence physical activity and sedentary behavior.