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Pulmonary Rehabilitation in Sleep Disorders affecting COPD

Institution: University of California, San Diego
Investigator(s): Xavier Soler, M.D., Ph.D.
Award Cycle: 2010 (Cycle 19) Grant #: 19KT-0014 Award: $270,000
Subject Area: Pulmonary Disease
Award Type: New Investigator Awards

Initial Award Abstract
Sleep-related disorders have become an important public health concern. These are defined as any condition affecting the quality of sleep, including insomnia and all breathing-related sleep disorders such as the sleep apnea/hypopnea syndrome (SAHS). SAHS is a condition where there is little or no air flow going to the lungs because of an obstruction in the upper airway during sleep leading to decrease of blood oxygen levels and disturbed sleep. This condition can present at any age and affects up to 5% of the general population leading to serious health problems such as heart diseases, stroke, erectile dysfunction, diabetes, and depression. Sleep disorders are associated with impaired quality of life. Little is currently known about sleep disorders in patients with chronic obstructive pulmonary disease (COPD), the most common chronic lung disease and a major health problem directly related to cigarette smoking. Current treatment options for sleep-related disorders include continuous nasal pressure devices (CPAP), nocturnal oxygen therapy, oral medications such as non-benzodiazepines drugs and behavior therapy. Given the paucity of information about the impact of sleep disorders and treatments specific for patients with COPD further investigation of these two common conditions is warranted. In other populations, exercise has been shown to improve sleep health. In patients with COPD, pulmonary rehabilitation (PR), including exercise training, has been shown to produce important health benefits such as improvement in symptoms, exercise tolerance, and quality of life. However, the effect of PR on sleep-related disorders has not been previously studied in such patients. The purpose of this proposal, therefore, is to better characterize sleep-related disorders in patients with disabling, moderate to severe COPD and evaluate the potential benefits of PR as a possible treatment to improve sleep health in these patients. Our hypotheses are that in patients with COPD: 1) sleep health is poor; 2) sleep-related disorders are common; 3) poor sleep health is related to other measures of poor health outcomes; and 3) pulmonary rehabilitation may improve sleep health and reduce sleep-related disorders.