Efficacy of Guided Imagery Training in Improving Sleep Quality in Patients With Chronic Obstructive Pulmonary Disease and Sleep Disorders

Abstract

Background: This work aimed to investigate the effectiveness of guided imagery training in improving sleep quality for patients with chronic obstructive pulmonary disease (COPD) and sleep disorders.

Methods: This retrospective cohort study utilised propensity score matching (PSM). Patients with stable COPD complicated by sleep disorders, treated at The Affiliated Wuxi People’s Hospital of Nanjing Medical University from March 2024 to June 2025, were consecutively identified through a retrospective review of medical records. Sixty patients who underwent guided imagery training combined with standard pharmacotherapy were assigned to the combined treatment group, and 109 patients who received standard pharmacotherapy alone were assigned to the control group. PSM (1:1 nearest neighbour matching without replacement, calliper = 0.02) was applied to balance the two groups, resulting in 53 patients per group for final analysis. The primary outcomes were sleep architecture parameters (e.g., sleep efficiency) and the Pittsburgh Sleep Quality Index (PSQI) score. Secondary outcomes included the Athens Insomnia Scale (AIS) score and pulmonary function indicators. Differences in sleep architecture parameters, AIS scores and PSQI scores were compared between the two groups before and after treatment.

Results: Before treatment, no statistically significant differences were observed between the two groups in terms of sleep efficiency, sleep latency, number of awakenings, apnoea–hypopnea index (AHI) or minimum oxygen saturation (p > 0.05). After treatment, both groups showed significant improvements, including increased sleep efficiency and minimum oxygen saturation (p < 0.05) and decreased sleep latency, number of awakenings and AHI (p < 0.05), compared with baseline. Post-treatment, the combined treatment group demonstrated significantly higher sleep efficiency and minimum oxygen saturation and significantly lower sleep latency, number of awakenings and AHI than the control group (p < 0.05). Regarding AIS and PSQI scores, no significant intergroup differences were found at baseline (p > 0.05). After treatment, both groups exhibited significant score reductions (p < 0.05), with the combined treatment group achieving significantly lower scores than the control group (p < 0.05).

Conclusions: In this retrospective cohort of patients with COPD and sleep disorders, the addition of guided imagery training to the standard pharmacotherapy was associated with significant improvements in subjective and objective sleep quality parameters. This approach may serve as a beneficial adjunctive therapy in this population.