COPD symptoms in the morning: impact, evaluation and management

Respir Res. 2013 Oct 21;14(1):112. doi: 10.1186/1465-9921-14-112.

Abstract

Chronic obstructive pulmonary disease (COPD) symptoms in the morning, including dyspnea and sputum production, affect patients' quality of life and limit their ability to carry out even simple morning activities. It is now emerging that these symptoms are associated with increased risk of exacerbations and work absenteeism, suggesting that they have a more profound impact on patients than previously thought. The development of validated patient-reported outcome (PRO) questionnaires to capture patients' experience of COPD symptoms in the morning is, therefore, vital for establishing effective and comprehensive management strategies. Although it is well established that long-acting bronchodilators are effective in improving COPD symptoms, the limited available data on their impact on morning symptoms and activities have been obtained with non-validated PRO questionnaires. In this review, we discuss the impact of COPD symptoms in the morning and available tools used to evaluate them, and highlight specific gaps that need to be addressed to develop standardized instruments able to meet regulatory requirement. We also present available evidence on the effect of pharmacological therapies on morning symptoms.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Absenteeism
  • Activities of Daily Living / psychology
  • Circadian Rhythm / physiology*
  • Drug Therapy
  • Humans
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Quality of Life / psychology
  • Risk Factors
  • Sickness Impact Profile*
  • Surveys and Questionnaires