Lung computed tomography (CT) imaging findings of chronic obstructive pulmonary disease patients with impaired sleep quality.

AIM: To investigate the computed tomography (CT) imaging characteristics (including diaphragm thickness [DT], pulmonary artery to aorta ratio [dPA/A], and airway indices) associated with impaired sleep quality in chronic obstructive pulmonary disease (COPD) patients.

MATERIALS AND

METHODS

This cross-sectional study enrolled 190 COPD patients (December 2021-September 2024). Baseline data included demographics, COPD Assessment Test (CAT) scores, pulmonary function, exacerbation history, and CT parameters. Impaired sleep quality was defined as Pittsburgh Sleep Quality Index (PSQI) score ≥5, grouping patients accordingly.

RESULTS

Patients (mean age 64.8 years; 93.1% male) included 56% with impaired sleep quality (linked to higher CAT scores and lower FEV1/FVC). The impaired sleep group had smaller airway lumen area (LA), mean inner/outer diameters (mID/mOD), and DT; plus higher wall area percentage (WA%) and dPA/A. DT, WA%, and dPA/A were independent risk factors for impaired sleep; dPA/A had the highest ROC AUC (0.688), followed by CAT (0.667), DT (0.632), and WA% (0.602).

CONCLUSION

Impaired sleep quality in COPD may relate to airway narrowing, airway wall thickening, reduced lumen diameter, and enlarged dPA/A.