Effect of ipratropium bromide treatment on oxygen saturation and sleep quality in COPD

Richard J. Martin, Bccki L. Bucki Bartclson, Philip Smith, David W. Hudgel, David Lewis, Gerhardt Pohl, Paul Koker, Joseph F. Sonhrada

Research output: Contribution to journalArticlepeer-review

84 Scopus citations


Study objectives: Patients with COPD are at risk of experiencing a deterioration in arterial oxygen saturation (SaO2) during sleep, which is generally most pronounced during rapid eye movement (REM) sleep. Increased cholinergic tone has been suggested as a contributing factor to this decrease in SaO2. Therefore, we investigated whether 4-week treatment with ipratropium bromide inhalation solution 0.02% (qid) could improve sleep characteristics in COPD. Design: Randomized, placebo-controlled, double- blind, two-arm parallel study of 4 weeks of treatment with ipratropium bromide solution or placebo. Setting: Multicenter investigation. Patients: Thirty-six patients with moderate-to-severe COPD (FEV1 < 65% of predicted). Measurements and results: Evaluation included polysomnographic, pulmonary function, and subjective quality of sleep (visual analog scale [VAS]) assessments. It was found that 4 week of treatment with ipratropium bromide solution in patients with COPD led to the following: (1) a significant (p = 0.05) improvement in mean nocturnal SaO2 with the more severe the nocturnal desaturation, the greater the improvement in SaO2; (2) significant (p = 0.03) improvement in perceived sleep quality (VAS: 5.5 ± 0.5 after placebo; 7.2 ± 0.5 after ipratropium); (3) a significant (p = 0.05) increase in REM sleep time (48.6 ± 6.3 min after placebo; 66.5 ± 6.4 min after ipratropium) with no effect on other sleep stages or to sleep time; and (4) a significant (p = 0.01) increase in pre-sleep FVC and flow rate at 50% of the vital capacity. Conclusions: These findings demonstrate that ipratropium bromide therapy can improve sleep SaO2 as well as sleep quality in patients with moderate-to-severe COPD.

Original languageEnglish (US)
Pages (from-to)1338-1345
Number of pages8
Issue number5
StatePublished - 1999
Externally publishedYes


  • COPD
  • Ipratropium bromide
  • Oxygen saturation
  • Sleep

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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