Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity.

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Title: Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity.
Authors: Spina, G
Spruit, MA
Alison, J
Benzo, RP
Calverley, PM
Clarenbach, CF
Costello, RW
Donaire-Gonzalez, D
Dürr, S
Garcia-Aymerich, J
Van Gestel, AJ
Gramm, M
Hernandes, NA
Hill, K
Hopkinson, NS
Jarreta, D
Kohler, M
Kirsten, AM
Leuppi, JD
Magnussen, H
Maltais, F
Man, WD
McKeough, ZJ
Mesquita, R
Miedinger, D
Pitta, F
Singh, SJ
Smeenk, FW
Tal-Singer, R
Vagaggini, B
Waschki, B
Watz, H
Wouters, EF
Zogg, S
Den Brinker, AC
Item Type: Journal Article
Abstract: BACKGROUND: 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. AIMS: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Issue Date: 12-Jan-2017
Date of Acceptance: 7-Dec-2016
ISSN: 0040-6376
Publisher: BMJ Publishing Group
Start Page: 694
End Page: 701
Journal / Book Title: Thorax
Volume: 72
Copyright Statement: © 2017 BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to This article has been accepted for publication in Thorax following peer review. The definitive copyedited, typeset version Spina G, Spruit MA, Alison J, et al Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity Thorax Published Online First: 12 January 2017. doi: 10.1136/thoraxjnl-2016-208900 is available online at:
Sponsor/Funder: Medical Research Council (MRC)
Funder's Grant Number: G0701628
Keywords: COPD Pathology
Respiratory System
1103 Clinical Sciences
Publication Status: Published
Conference Place: England
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine

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