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Poor Sleep Increases Risk of Life-threatening COPD Flare-ups, According to Study


In a new study, poor sleep was linked to an increased risk of life-threatening flare-ups in people with chronic obstructive pulmonary disease (COPD).

An observational study1 supported by the National Institutes of Health found that poor sleep was associated with a significantly increased risk of life-threatening flare-ups in patients with chronic obstructive pulmonary disease (COPD).

The study included 1647 people with confirmed COPD who enrolled in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS), which is a multicenter, US longitudinal study that was designed to evaluate COPD subpopulations, outcomes, and biomarkers.

All participants were current or former tobacco smokers with confirmed COPD. Each participant also had 1 sleep evaluation on enrollment. Researchers evaluated COPD flare-ups over a 3-year follow-up period for each patient and compared the measurements against sleep quality of each participant. Sleep duration, timing of sleep, and frequency of disturbances were included in the analysis of self-reported sleep quality.

The researchers adjusted for socio-environmental exposures with the Area Deprivation Index, which is a composite measure of neighborhood quality, and the Adversity-Opportunity Index, which is a composite measure of individual-level historic and current socioeconomic indicators.

Poor sleep quality was associated with more COPD flare-ups compared with those with the best quality of sleep. Patients at the threshold or base level of poor sleep had a 25% increased risk of having a COPD flare-up within a year. Patients with the worst sleep quality had a 95% increased risk of having a COPD exacerbation in the next year.

The study also found that increasing Pittsburgh Sleep Quality Index Scores were associated with a 5% increased risk of exacerbation per point in the dataset.

Aaron Baugh, the lead study author, said that these results have implications on Black Americans who generally have poorer sleep quality than other races and ethnicities in a news release.2 Poor sleep is now linked to COPD, which may explain why Black Americans tend to do worse when diagnosed with COPD compared with other racial and ethnic groups.

Marishka Brown, director of the NHLBI’s National Center on Sleep Disorders Research, said “This study adds to a growing base demonstrating the harmful effects of poor sleep on health in general but can be particularly damaging in people with devastating preexisting conditions, such as COPD.”


  1. Baugh A, Buhr RG, Quibrera P, et al. Risk of COPD exacerbation is increased by poor sleep quality and modified by social adversity. Sleep. Published online June 6, 2022. doi:10.1093/sleep/zsac107
  2. NIH-supported study links poor sleep to increased risk of COPD flare-ups. News Release. National Institutes of Health. June 6, 2022. Accessed June 6, 2022. https://www.nih.gov/news-events/news-releases/nih-supported-study-links-poor-sleep-increased-risk-copd-flare-ups
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