Inverse association between daily activity and sleep activity and related factors in elderly patients with chronic obstructive pulmonary disease and bronchial asthma

ABSTRACTBackgroundTo test the hypothesis that both daily activities and sleep quality may be mutually disturbed in elderly subjects with chronic obstructive pulmonary disease (COPD) or bronchial asthma (BA) and to determine factor(s) that relate to deterioration.MethodsElderly subjects with chronic airflow obstruction (group R; n = 60), consisting of COPD and BA, were compared with subjects without respiratory symptoms (group C; n = 53). Both daily activities and sleep quality were assessed by force-gravity (GF) measurement using an accelerometer.ResultsThe night study showed that both total sleeping period and frequency of GF in group R were increased significantly compared with group C. Subjects with BA showed fewer movements differing from those in COPD subjects. The daytime study indicated that the frequency of GF was greater in group C than in group R, suggesting reduced daily activities in group R. Subjects with BA showed more movement than COPD subjects. Hypercapnia was a significant factor causing COPD subjects to move more frequently during sleep and a decrease in peak flow rate was a significant factor in the reduction of movement during the day in subjects with BA.ConclusionsIt is assumed that elderly subjects with COPD or bronchial asthma require a longer sleep period than subjects without respiratory symptoms because of the deterioration of sleep quality in the former group and the sleeping pattern differs between subjects with COPD and BA. Hypercapnia is considered a possible factor disturbing sleeping quality in COPD, whereas decreased peak expiratory flow rate is a factor reducing daytime activities in subjects with BA