Abstract
This study aimed to assess the sleep quality among patients diagnosed with chronic obstructive pulmonary disease (COPD) and identify associated factors. A convenience sampling method was employed to distribute questionnaires to COPD patients at the Department of Respiratory and Critical Care Medicine in a tertiary hospital in Inner Mongolia between January and May 2025. This study has been approved by the Ethics Committee of Inner Mongolia Medical University, with ethics number KY2025086. A cross-sectional survey utilized the General Information Questionnaire, Mandarin Chinese for China version of the Pittsburgh Sleep Quality Index, COPD assessment test, self-efficacy for managing chronic disease 6-item scale, and Short Questionnaire of the International Physical Activity Questionnaire to evaluate factors influencing sleep quality in COPD patients. Directed acyclic graphs were utilized for covariate identification. Gender, age, per capita household income, smoking status, education level, physical activity level, self-efficacy, and CAT were incorporated into the stepwise linear regression model. Four models were evaluated in total. Out of 220 distributed questionnaires, 201 were collected, yielding an effective response rate of 91.36%. The mean PSQI score was 10.07 ± 4.23. The distribution of physical activity levels revealed 164 (81.6%) individuals with low activity, 32 (15.9%) with moderate activity, and 5 (2.5%) with high activity. Regarding the impact of COPD on health and life, 7 (3.5%) had mild impact, 70 (34.8%) moderate impact, 109 (54.2%) severe impact, and 15 (7.5%) very severe impact. In the study, 132 individuals (65.7%) exhibited low self-efficacy levels, while 52 (25.9%) had medium levels, and 17 (8.5%) had high levels. Four models were tested through stepwise regression analysis. The fourth model demonstrated a favorable fit (R2 = 0.346) and revealed no multicollinearity. The analysis identified age, gender, CAT, and self-efficacy as significant determinants of sleep quality in patients with COPD. The findings suggest that individuals with COPD experience poor sleep quality, with a higher risk of sleep disorders observed among female, elderly patients with lower self-efficacy levels and more severe COPD symptoms.