Prevalence of night-time dyspnoea in COPD and its implications for prognosis

TY - JOUR

T1 - Prevalence of night-time dyspnoea in COPD and its implications for prognosis

AU - Lange, Peter

AU - Marott, Jacob Louis

AU - Vestbo, Jørgen

AU - Nordestgaard, Børge Grønne

N1 - ©ERS 2014.

PY - 2014/6

Y1 - 2014/6

N2 - The information on night-time symptoms in chronic obstructive pulmonary disease (COPD) is sparse. We investigated the prevalence of night-time dyspnoea in 6616 individuals with COPD recruited from the general population in the Copenhagen area, Denmark, and described characteristics and prognosis of subjects with this symptom. The prevalence of night-time dyspnoea was 4.3%: 2.1% in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A, 12.9% in GOLD B, 2.6% in GOLD C and 16.3% in GOLD D. Compared with individuals without night-time dyspnoea, those with night time dyspnoea had lower forced expiratory volume in 1 s, higher daytime dyspnoea scores (modified Medical Research Council scale) and more wheezing, more often had chronic mucus hypersecretion, ischaemic heart disease and atrial fibrillation, and more often reported stress, nervousness and tiredness. After adjustment for age and sex, the presence of night-time dyspnoea was associated with future COPD exacerbations (hazard ratio (HR) 2.3, 95% CI 1.7-3.0), hospital admissions due to COPD (HR 3.2, 95% CI 2.3-4.4) and mortality (HR 1.7, 95% CI 1.2-2.3). Prevalence of night-time dyspnoea in COPD increases with disease severity according to both spirometric and clinical GOLD classification, and is associated with presence of daytime respiratory symptoms and cardiac comorbidities. Night-time dyspnoea is a significant predictor of poor prognosis in individuals with COPD.

AB - The information on night-time symptoms in chronic obstructive pulmonary disease (COPD) is sparse. We investigated the prevalence of night-time dyspnoea in 6616 individuals with COPD recruited from the general population in the Copenhagen area, Denmark, and described characteristics and prognosis of subjects with this symptom. The prevalence of night-time dyspnoea was 4.3%: 2.1% in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A, 12.9% in GOLD B, 2.6% in GOLD C and 16.3% in GOLD D. Compared with individuals without night-time dyspnoea, those with night time dyspnoea had lower forced expiratory volume in 1 s, higher daytime dyspnoea scores (modified Medical Research Council scale) and more wheezing, more often had chronic mucus hypersecretion, ischaemic heart disease and atrial fibrillation, and more often reported stress, nervousness and tiredness. After adjustment for age and sex, the presence of night-time dyspnoea was associated with future COPD exacerbations (hazard ratio (HR) 2.3, 95% CI 1.7-3.0), hospital admissions due to COPD (HR 3.2, 95% CI 2.3-4.4) and mortality (HR 1.7, 95% CI 1.2-2.3). Prevalence of night-time dyspnoea in COPD increases with disease severity according to both spirometric and clinical GOLD classification, and is associated with presence of daytime respiratory symptoms and cardiac comorbidities. Night-time dyspnoea is a significant predictor of poor prognosis in individuals with COPD.

KW - Aged

KW - Denmark

KW - Dyspnea

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Mucus

KW - Myocardial Ischemia

KW - Prevalence

KW - Prognosis

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Pulmonary Disease, Chronic Obstructive

KW - Questionnaires

KW - Respiratory Sounds

KW - Sleep Disorders

KW - Stress, Psychological

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1183/09031936.00196713

DO - 10.1183/09031936.00196713

M3 - Journal article

C2 - 24488571

SN - 0904-1850

VL - 43

SP - 1590

EP - 1598

JO - Acta tuberculosea Scandinavica

JF - Acta tuberculosea Scandinavica

IS - 6

ER -