Investigation on the Relationship between Sleep Quality and Depression and Anxiety in Hospitalized Patients with Different Levels of AECOPD

PURPOSE: To explore the correlations between sleep quality and depression and anxiety in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: A total of 131 AECOPD patients treated at No.6th People's Hospital affiliated to Shanghai Jiao Tong University School from January 2018 to December 2020 were selected and divided into the classes I (n = 30), II (n = 23), III (n = 37), and IV (n = 41) based on the severity of AECOPD. The Pittsburgh sleep quality index (PSQI) and the hospital anxiety and depression scale (HADS) were employed to assess the quality of sleep and anxiety/depression in AECOPD patients. The Pearson correlation analysis explored the associations between PSQI score and HADS anxiety/depression score. Binary logistic regression was utilized to determine risk factors for anxiety/depression in AECOPD patients. RESULTS: The PSQI score, HADS anxiety score, and HADS depression score in patients with AECOPD class III and class IV were significantly higher than those of classes I and II. The severe anxiety and depression ratio were significantly different among patients with classes I–IV AECOPD. The severity of AECOPD was significantly correlated with the PSQI score (r = 0.51, P < 0.001), HADS anxiety score (r = 0.66, P < 0.001), and HADS anxiety score (r = 0.65, P < 0.001). Binary logistic regression analysis showed that the COPD duration, the severity of AECOPD, and PSQI score were the risk factors for anxiety and depression in patients with AECOPD. CONCLUSIONS: Poor sleep quality, anxiety, and depression are common in patients with AECOPD. Improvement of sleep quality may help to alleviate anxiety and depression in AECOPD patients.