1. Sleep Disturbance & Psychological Functioning in Respiratory Diseases Daljinder Virk 1, Rebecca Stores 1 & Anoop Chauhan 2 1 School of Health Sciences and Social Work, University of Portsmouth, UK 2 Portsmouth Hospitals NHS Trust, Portsmouth, UK Corresponding Author: dally.virk@port.ac.uk Method: Design This study will be a cross-sectional questionnaire survey of individuals with specific respiratory diseases and a matched control group. Subjects Individuals with respiratory diseases Individuals with specific respiratory disease will be recruited through the Portsmouth respiratory services clinical register. The total number of individuals currently on this database is 5,304. The number of individuals with specific diagnoses are: asthma - 920; chronic obstructive pulmonary disease (COPD) - 1002, asbestosis - 47, asbestos pleural plaques - 270, asbestos pleural thickening - 83 and bronchiectasis - 271. Controls Control individuals will be recruited via the WReN GP practices within Hampshire. These will be matched for age, sex, socio-economic status and geographical location. Assessments All questionnaires will be established, psychometrically sound and of relevance to this study. They are as follows: Background: Sleep disturbance is a common complaint in various respiratory diseases (Lewis, 1999). Although this area has been the topic of some research, certain respiratory disorders, such as sleep apnoea and chronic obstructive pulmonary disease (COPD), have received more attention than others. In addition, much of the research has been physiological in nature investigating sleep disturbance in terms of objective measures rather than assessing the sleep complaints of the individuals themselves. Severe sleep disturbance can have a range of negative daytime consequences including excessive daytime sleepiness, decreased quality of life and cognitive impairment. Impaired quality of life and cognitive function have been the topic of some research in sleep apnoea (Engleman & Douglas, 2004) but not in other respiratory conditions. It is often the case that these daytime symptoms are more important to the individual than the nocturnal respiratory events on which clinicians tend to focus. The proposed research is novel in its approach in that: it will study sleep disturbance in a range of respiratory diseases, some of which have received little or no previous attention, it will focus on self reported aspects of sleep disturbance, it will explore associations between self reported sleep disturbance and a range of daytime measures: daytime sleepiness, quality of life and cognitive functioning. Aims: This study will consist of a large scale questionnaire survey. The aims are: to describe the occurrence and nature of self reported sleep problems in patients who have been diagnosed with specific respiratory diseases inlcuding asthma, chronic obstructive pulmonary disease (COPD), asbestosis, and bronchiectasis. to compare the findings with a control group matched for age, sex, socio- economic status and geographical location. to investigate associations between the sleep problems and self reported daytime sleepiness, quality of life and daytime cognitive functioning in the groups with respiratory disease. References: Beck AT, Ward CH, Mendelson M, Mock J & Erbaugh J (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571. Engleman HM & Douglas NJ (2004) Sleepiness, cognitive function and quality of life in obstructive sleep apnoea/hypopnoea syndrome. Thorax, 59, 618- 622. Goldberg D & Williams P (1988) A User ’ s Guide to the General Health Questionnaire. Windsor UK: NFER-Nelson. Jennum P & Sjol A (1994) Self assessed cognitive function in snorers and sleep apnoeics. An epidemiological study of 1,504 females and males aged 30-60 years: the Dan-MONICA II Study. European Neurology, 34, 204-208. Johns MW (1991) A new method of measuring daytime sleepiness scale. Sleep, 14, 6, 540-545. Lewis DA (1999) Sleep in patients with respiratory disease. Respiratory Care Clin N Am, 5, 3, 447-460. Partinen M & Gislason T (1995) Basic Nordic Sleep Questionnaire (BNSQ): a quantitated measure of subjective sleep complaints. Journal of Sleep Research, 4, 1, 150-155. Ware JE & Sherbourne CD (1992) The SF-36 health status survey, I: Conceptual framework and item slection. Medical Care, 30, 473-483. Sleep Disturbance: Basic Nordic Sleep Questionnaire (BNSQ) (Partinen & Gislason 1995) Daytime sleepiness: Epworth Sleepiness Scale (ESS) (Johns 1991) Quality of life: 36-Item Short Form Health Survey (SF-36) (Ware & Sherbourne 1992) Cognitive Functioning: Specific items relating to self assessed concentration and memory problems (Jennum & Sjol 1994). Mental Health: The General Health Questionnaire (GHQ) (12 item version) (Goldberg & Williams 1988). The Beck Depression Inventory (BDI) (Beck, Ward, Mendelson, Mock & Erbaugh 1961). Analysis Analysis of variance (ANOVAs) will be used to compare the occurrence of sleep problems between the respiratory disease and control groups. Correlation and logistic regression will be used to explore associations between the sleep disorders, quality of life, mood and daytime cognitive functioning in the groups with respiratory disease. Intervention Study: Once completed, this study will lead naturally to a pre- and post- treatment study to explore whether treatment of the respiratory disease is associated with improvement of sleep disturbance and psychological functioning.