Chest
Volume 105, Issue 1, January 1994, Pages 151-154
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Clinical Investigations: Sleep
The Relation of Sleep Complaints to Respiratory Symptoms in a General Population

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Based on data obtained from the Tucson Epidemiologic Study of Chronic Lung Disease that included body weight, questionnaire responses, and spirometry, we found that among subjects with no respiratory symptoms, 28.0 percent reported insomnia (difficulty initiating or maintaining sleep) and 9.4 percent reported daytime sleepiness. Among subjects with respiratory symptoms, cough and/or wheeze, the rates of sleep complaints increased. With one symptom, 39.1 percent reported insomnia and 12.4 percent reported daytime sleepiness. With both symptoms, the rates were 52.8 percent and 22.8 percent, respectively. Overall, we found significant relationships between rates of respiratory symptoms and sleep complaints (trend χ2 = 73.9, p < 0.001 for insomnia; trend χ2 = 37.9, p<0.001 for daytime sleepiness). In separate analyses, obesity, snoring, and a diagnosis of lung disease also influenced the rate of sleep complaints but, when we employed logistic regression, we found that obesity, respiratory symptoms, gender, and age were the only variables related to the risk of insomnia or daytime sleepiness.

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Methods and Materials

The design of the Tucson Epidemiologic Study of Obstructive Airways Disease (TESOAD) from which these data are derived has been reported in detail previously.4 Briefly, the study is a stratified random cluster sample of white, non-Hispanic households residing in Tucson, which have been surveyed prospectively at 1- to 2-year intervals starting in 1972. Details of the methods used in the surveys and in data compilation have been published previously, including the development of percent predicted

Results

In our first set of analyses, we examined the rates of DIMS and EDS when the subjects were grouped according to their respiratory symptoms. For purposes of comparisons among subjects, we formed three exclusive groups: subjects with no respiratory symptoms; subjects with one symptom (either cough or sputum production or wheezing at least apart from colds); and subjects with both cough or sputum and wheezing apart from colds. Among the subjects with no respiratory symptoms, as shown in Table 1,

Discussion

Several authors have found that patients with chronic obstructive lung disease have more sleep complaints than controls. Kinsman and his coworkers3 reported that sleep difficulties ranked third after dyspnea and fatigue in their 146 patients attending pulmonary clinics. Nearly one half of the patients had sleep difficulties “always” or “almost always.” Cormick and his coworkers2 studied 50 patients with chronic obstructive pulmonary disease (COPD) and found that 36 percent of the patients had

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Supported by National Heart Lung and Blood Institute Specialized Center of Research Grant HL-14136.

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