Flare-ups, which present as increased shortness of breath and cough, have the potential to induce irreparable lung damage over time, speeding disease progression and mortality.

According to a study done by UC San Francisco researchers, insufficient or disrupted sleep may have a greater impact on people with progressive lung disease than smoking history.

Patients with COPD (chronic obstructive pulmonary disease) who don’t get enough sleep had a 95 percent higher chance of having a flare-up than those who get enough sleep, according to the study.

Researchers tracked “flare-ups,” defined as short-term exacerbation of symptoms requiring treatment, throughout a three-year period and related their frequency to self-reported data on sleep quality.

These flare-ups, which are characterized by growing shortness of breath and cough, have the potential to cause irreparable lung damage and increase disease progression and mortality.

The researchers followed 1,647 COPD patients who were included in the national, multi-center SPIROMICS study. The research looked at how the condition progressed and how successful therapies were.

The study appeared in SLEEP on June 6, 2022.

According to Aaron Baugh, MD, a clinical fellow at the UCSF Division of Pulmonary, Critical Care, Allergy and Sleep Medicine and the Cardiovascular Research Institute, the findings could help explain why African American patients with COPD have a worse prognosis than white patients.

“African Americans are over-represented in low-income neighborhoods, where people are less likely to have good quality sleep. They may live in crowded spaces with multiple roommates, and have less comfortable sleeping conditions, such as a couch, and they may work in a job with a varying schedule that lends itself to sleep disruption ,” Baugh explained.

“Research shows sleep deprivation is associated with a drop in infection-fighting antibodies and protective cytokines,” he continued.

The average age of the participants at the start of the trial was 65, and the average stage of the disease was moderate. Over half of the participants (57 percent) were men, with 80 percent being white and 14 percent being African-American.

When the study began, all of the participants were current or past smokers who had undergone at least one sleep test. Researchers discovered that, as compared to people with adequate sleep, those with poor sleep had a 25 percent higher likelihood of having a flare-up within the next year, reaching to nearly 95 percent for those with the worst sleep.

“While factors like health insurance coverage or respiratory hazards may play important roles in severity of the disease,” Baugh added, “poor sleep may gain even more significance when African Americans’ social status improves.” “This can lead to a kind of paradox; in reducing one risk factor, a new risk factor – poor sleep – may take its place.”

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