Poor Sleep Quality and Reduction of the Level of Physical Activity in Daily Life Over 1 Year in Individuals with COPD: Preliminary Results

Keywords

chronic obstructive pulmonary disease - sleep - physical activity in daily life

Introduction: It is well-established that individuals with chronic obstructive pulmonary disease (COPD) exhibit low levels of physical activity in daily life (PADL), which is an important predictor of mortality in this population. Sleep has been identified in cross-sectional studies as a factor linked to the level of PADL in individuals with COPD; however, it remains unclear whether poor sleep quality is associated with changes in PADL in a prospective cohort.

Objective: To analyze whether individuals with COPD and poor sleep quality exhibit changes in PADL over a 1-year follow-up, and whether this change is comparable between sexes.

Methods: In a prospective cohort, individuals with COPD and poor sleep quality classified through the Pittsburgh Sleep Quality Index (PSQI) with a score >5 at baseline were included. The level of PADL was assessed at both time points (baseline [AV1] and after 1 year [AV2]) with the Actigraph accelerometer used at the waist for 7 consecutive days. Shapiro-Wilk test and paired T-test were used for the statistical analyses, with SPSS 20.0 as the adopted software and P<0.05 as statistical significance.

Results: Eighteen individuals with COPD and poor sleep quality were included (11 men; age: 71[65-74] years; BMI: 28[25-32] kg/m²; FEV1: 59[50-78] % predicted; baseline PSQI: 8[7-11] points). Regarding PADL variables, when comparing AV1 versus AV2, there was a reduction in light physical activity (PA) in minutes/day (322[253-397] versus 268[202-346]; p= 0.019) and also in % of the day (39[32-46] versus 33[27-42]%; p=0.006). Sedentary time (in % of the day) increased when comparing AV1 and AV2 (60[53-67] versus 66[57-72] respectively; p=0.012). When comparing AV1 and AV2 in terms of sex, men decreased light PA in minutes/day (38[28-44] versus 35[27-43]; p=0.031), while women reduced light PA (in % of the day) (41[38-47] versus 32[24-42]; p=0.011) and increased sedentary time (in % of the day) (58[51-60] versus 67[57-75]; p=0.010).

Conclusion: Individuals with COPD and poor sleep quality exhibit a decline in PADL levels over a 1-year follow-up, characterized by increased sedentary time and decreased light PA. Upon analyses by sex, women demonstrated worsening in both characteristics (sedentary time and light PA), while men only reduced light PA.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
16 September 2025