International journal of chronic obstructive pulmonary disease
Why Sleep Matters in COPD: Cluster-Derived Sleep Phenotypes Reveal Distinct Physiological, Comorbidity and Survival Profiles
By Hansson D, Lisik D, Andersson A and 4 others.
Abstract
Background
Sleep disturbances are highly prevalent in chronic obstructive pulmonary disease (COPD) but are not incorporated into current phenotypic classifications. We examined whether multidimensional sleep data identify clinically relevant patterns in COPD and whether these patterns are associated with all-cause mortality.
Methods
In a clinical cohort of 205 patients with COPD, home-based sleep assessment was performed using the WatchPAT™ device. Fifteen complementary variables reflecting sleep duration and architecture, nocturnal oxygenation, sleep-disordered breathing, and daytime sleepiness were analysed using Partitioning Around Medoids clustering. The resulting phenotypes were characterised by pulmonary function, gas exchange, functional capacity, systemic biomarkers, and comorbidity burden. Longitudinal follow-up was available for 199 participants; survival was assessed using Kaplan-Meier analysis and Cox regression adjusted for age, sex, post-bronchodilator FEV1 and positive airway pressure (PAP) treatment.