Effects of endobronchial coils for endoscopic lung volume reduction on sleep in COPD patients with advanced pulmonary em
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE
Effects of endobronchial coils for endoscopic lung volume reduction on sleep in COPD patients with advanced pulmonary emphysema Karl-Josef Franke 1,4 & Ulrike Domanski 2 & Maik Schröder 3
&
Georg Nilius 3,4
Received: 8 May 2020 / Revised: 5 August 2020 / Accepted: 19 August 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose Treatment of advanced pulmonary emphysema with endobronchial coils can improve clinical outcomes like quality of life (QOL). Yet, patients with chronic obstructive pulmonary disease (COPD) are also known to suffer from reduced sleep quality. The effect of coil therapy on sleep has not yet been investigated. The primary aim of this study was to investigate sleep efficiency before and after coil treatment. Secondly, we investigated the effects on nocturnal breathing pattern, QOL, and physical activity. Methods Polysomnography (PSG) testing was performed before (T0), 6 month after (T3), and 12 months after (T4) treatment with endobronchial coils. Further examinations included QOL by St George’s Respiratory Questionnaire (SGRQ) and COPD assessment test (CAT), and physical activity using an accelerometer for 1 week after each visit. Results Of 21 patients, 14 completed the study: 6 women; mean age 58.0 ± 4.9 years; BMI 22.6 ± 4.6 kg/m2; FEV1 28.6 ± 7.1% predicted; residual volume (RV) 278.2 ± 49.4% predicted. Sleep efficiency did not vary between baseline and follow-up examinations (T0 69.0 ± 15.8%; T3 70.9 ± 16.0%; T4 66.8 ± 18.9%). Non-REM respiratory rate decreased compared to baseline (T0 19.4 ± 3.9/min; T3 17.8 ± 3.5/min; T4 17.1 ± 3.1/min (p = 0.041; p = 0.030) and QOL improved meeting the minimal clinically important difference (MCID) (SGRQ, T3 −12.8 units; T4 −7.1 units; CAT: T3 −5.6 units; T4 −3.4 units). No increase in physical activity was recorded (light activity T0 31.9 ± 9.9; T3 30.8 ± 16.9; T4 26.3 ± 10.6 h/week). Conclusions Treatment with endobronchial coils did not influence objectively measured sleep quality or physical activity, but reduced nocturnal breathing frequency and improved QOL in severe emphysema patients. Trial registration ClinicalTrials.gov Identifier: NCT02399514, First Posted: March 26, 2015 Keywords Endobronchial coils . Lung volume reduction . PSG . Sleep . Quality of life . Physical activity
Introduction Up to 23% of chronic obstructive pulmonary disease (COPD) patients are suffering from excessive daytime sleepiness, which correlates with the severity of respiratory symptoms [1]. During sleep even in healthy subjects, respiratory center responses and muscle responses to respiratory center outputs are impaired.
* Maik Schröder [email protected] 1
Märkische Kliniken GmbH, Klinikum Lüdenscheid, Lüdenscheid, Germany
2
VAMED Klinik Hagen-Ambrock GmbH, Hagen, Germany
3
Kliniken Essen-Mitte, Essen, Germany
4
Witten-Herdecke University, Witten, Germany
This results in a reduction of tidal volume due to diminished inspiratory drive and increased inspiratory loads with increased airw
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