Effects of Poor Sleep on COPD Exercise and Treatment

by Martin Reed Patient Advocate

There is a strong link between sleep issues and chronic obstructive pulmonary disease (COPD). Not only does COPD reduce sleep quality, but poor sleep quality can worsen COPD symptoms. This can lead to a vicious cycle of progressively worse sleep and progressively more severe COPD symptoms.

Although exercise training may improve the symptoms of COPD, a more recent study suggests that those with COPD may be less capable of exercising.

Poor sleep and COPD makes exercise more difficult

The study published in The Clinical Respiratory Journal in 2015 involved 103 individuals with an average age of 71. All participants had stable COPD. The sleep of each participant was assessed using the Pittsburgh Sleep Quality Index, allowing participants to be divided into one group of good sleepers and one group of poor sleepers.

Each participant was tested to assess:

  • Symptoms of depression

  • Symptoms of anxiety

  • Pulmonary function

  • Exercise capability

  • Quality of life

Exercise capability was measured using the 6MWD test, which involves walking as fast as possible for six minutes while technicians measure heart rate, oxygen saturation, dyspnea, and leg fatigue.

Researchers found that 44 percent of participants had poor sleep quality. Those with poor sleep quality demonstrated higher rates of anxiety, depression, and poorer quality of life and exercise capability scores compared to good sleepers.

The study also revealed that poor sleepers with COPD had less muscle strength in their quadriceps compared to good sleepers.

Researchers pointed out that not only was poor sleep found to have a negative effect on exercise capability, but poor exercise capability also had a negative effect on sleep quality.

This suggests that interventions to improve exercise capability may also improve sleep quality, and that interventions to improve sleep quality may lead to increased exercise capability — but more studies are needed before we can reach this conclusion with any certainty.

Why is exercise more difficult when you have COPD?

The study suggested that those with COPD may find exercise more difficult due to:

  • Pulmonary conditions

  • Nutritional imbalances

  • Cardiovascular abnormalities

  • Psychological disorders such as anxiety and depression

  • Decreased muscle strength and endurance (skeletal muscle dysfunction)

Vitamin supplements for COPD

One study found that increasing your intake of vitamin C may help alleviate COPD symptoms. If you have been prescribed glucocorticoids, you also may want to increase your intake of calcium and vitamin D as the drug is known to reduce bone mass and increase osteoporosis risk.

The authors of the The Clinical Respiratory Journal study pointed out that exercise intolerance appeared to be influenced by a decreasing trend of quadriceps muscle strength in those with poor sleep — which may be a result, in part, of muscle atrophy and protein metabolic imbalance.

Consequently, increasing protein intake may be beneficial when it comes to tackling malnourishment and muscle atrophy — but again, more studies are needed.

The best exercise for COPD

The COPD Foundation states that exercising correctly and safely is one of the best things you can do to alleviate dyspnea. Walking can be particularly helpful, and can help fight progressive de-conditioning.

Breathing techniques for COPD can also help tackle breathlessness, which may make some people more averse to exercise.

Be sure to speak with your doctor before starting a new activity or exercise program.

Take steps to improve your sleep

Although COPD symptoms can have a strong influence on the quality of your sleep, there are still a number of steps you can take to give yourself the best chance of a good night's sleep.

First, it's worth speaking with your doctor to determine whether your sleep is being further interrupted by a sleep-related breathing disorder such as obstructive sleep apnea.

Next, make sure you practice good sleep hygiene; avoid alcohol and other stimulants; and try replacing negative sleep thoughts with positive sleep thoughts.

Finally, you may find that sleeping on your side is more comfortable than sleeping on your back, as sleeping on your side helps open up the airways.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.