Prevalence of insomnia in patients with chronic obstructive pulmonary disease and its relationship with bronchodilator drugs

Objective: Taking under consideration that sleep disorders are reported to be an important health problem in COPD cases, and on the basis of the hypothesis stating that frequently used bronchodilators in these patients may disrupt sleep patterns, this study was aimed to investigate the frequency and causes of insomnia in patients with COPD and to investigate the effects of bronchodilators on insomnia. Material and Methods: Patients with COPD who applied to Karadeniz Technical University Chest Diseases between January 2019 and December 2020 and who met the inclusion criteria were included in the study. The patients' demographic characteristics, symptoms, comorbid illnesses, treatments used and their inpatient SFT values were recorded. The existance of insomnia in all participants were questioned using the mMRC dyspnea scale, the Epworth Sleepiness Scale, the Athens insomnia scale and the American Academy of Sleep Medicine insomnia criteria. The effects of long acting beta agonists, long acting anticholinergics and theophylline treatments on the prevalance of insomnia were studied. Short-acting beta 2 agonists, short-acting anticholinergics and inhaler corticosteroids were not included in the statistical analysis due to their short acting nature. Findings: 215 patients with an average age of 68.47±11.13 years (F: 65.09±16.37, M: 68.86±10.36) (193 male, 22 female) were included. Of the patients; %29.8 had mild, %36.7 had moderate, %33.5 had severe COPD. Insomnia was detected in %37.7 of COPD cases. Insomnia was detected in %59.5 of the patients using long acting bronchodilators with theophylline, and in %34.4 of the patients using only long acting bronchodilators (p=0.007). It was detected that the insomnia risk was 4.923 times higher in patients using long acting bronchodilators with theophylline, compared to non-users of long acting bronchodilators (p=0.011). Results and Conclusion: In our study, it was observed that long acting bronchodilators have effects on insomnia prevalence, and that this effect was intesified when they were taken with theophylline. It was emphasized that the relationship between bronchodilators and insomnia, which has limited data in the literature, is important on the treatment regimen in patients with COPD and that insomnia should be questioned alongside treatment in clinic controls.