Pulmonary Rehabilitation in COPD Did Not Improve Sleep Quality

pulmonary rehabilitation walking exercise
In patients with COPD, sleep parameters were not significantly improved after completion of a pulmonary rehabilitation program.

In patients with chronic obstructive pulmonary disease (COPD), sleep parameters were not significantly improved after completion of a pulmonary rehabilitation program, according to a study published in the Journal of Chronic Obstructive Pulmonary Disease.

Researchers completed a secondary analysis of data from 2 clinical trials to assess the affect pulmonary rehabilitation has on sleep quality using actigraphy, an activity-based sleep-wake monitoring armband. Patients who were diagnosed with COPD, had a smoking history and were free from respiratory exacerbations for the previous 4 weeks, were included in the study. Pulmonary rehabilitation assessments and sleep quality parameters were measured before and after an 8-week pulmonary rehabilitation program.

Of the 48 participants included in the study, 21 were men, and the mean age was 70. A total of 35 participants completed center-based pulmonary rehabilitation, and 13 completed home-based pulmonary rehabilitation. Before the pulmonary rehabilitation program, sleep efficiency was relatively poor at 75%. The pulmonary rehabilitation program led to improvements in 6-minute walk distance (P =.001), COPD assessment test (P =.027), Chronic Respiratory Disease Questionnaire: Dyspnea scores (P <.001), fatigue values (P =.005), emotional function (P =.003), and mastery (P <.001). Sleep efficiency after the pulmonary rehabilitation program only increased to 77% (P =.2). Even when analyzing group differences between the participants who completed ≥70% of the rehabilitation program and those who completed less, the sleep parameters from baseline to the postpulmonary rehabilitation program were not significantly different.

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Limitations of this study included data pooled from only 2 different clinical trials, participants not completing a sleep diary, and not including participant’s perception of sleep quality.

The researchers concluded that “[s]leep quality, measured objectively using actigraphy, did not improve after an 8-week pulmonary rehabilitation program in individuals with COPD.”


Cox NS, Pepin V, Burge AT, et al. Pulmonary rehabilitation does not improve objective measures of sleep quality in people with chronic obstructive pulmonary disease [published online March 19, 2019]. COPD. doi:10.1080/15412555.2019.1567701