In this retrospective propensity-score-matched cohort of patients with COPD and sleep disorders, the addition of guided imagery training to standard pharmacotherapy was associated with significant improvements in subjective and objective sleep quality parameters, and may serve as a beneficial adjunctive therapy in this population.
Key Findings
Methods
After propensity score matching, 53 patients per group were analyzed, drawn from 60 patients receiving guided imagery plus standard pharmacotherapy and 109 receiving standard pharmacotherapy alone.
Retrospective cohort study of 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.
PSM used 1:1 nearest neighbour matching without replacement with a calliper of 0.02.
Primary outcomes were sleep architecture parameters (e.g., sleep efficiency) and PSQI score; secondary outcomes were AIS score and pulmonary function indicators.
Results
Before treatment, the matched groups did not differ significantly in baseline sleep architecture parameters.
No statistically significant differences in sleep efficiency, sleep latency, number of awakenings, AHI or minimum oxygen saturation (p > 0.05).
Baseline AIS and PSQI scores also did not differ significantly between groups (p > 0.05).
Results
Both groups showed significant improvements in sleep architecture parameters after treatment compared with baseline.
Sleep efficiency and minimum oxygen saturation increased (p < 0.05).
Sleep latency, number of awakenings and AHI decreased (p < 0.05).
Results
After treatment, the combined guided imagery group had better sleep architecture than the control group.
Significantly higher sleep efficiency and minimum oxygen saturation in the combined group (p < 0.05).
Significantly lower sleep latency, number of awakenings and AHI in the combined group than in controls (p < 0.05).
Results
Both groups had significant reductions in AIS and PSQI scores after treatment, with greater reductions in the combined treatment group.
Both groups showed significant score reductions from baseline (p < 0.05).
Post-treatment, the combined treatment group had significantly lower AIS and PSQI scores than the control group (p < 0.05).
Conclusions
The authors conclude that guided imagery added to standard pharmacotherapy was associated with improved subjective and objective sleep quality in COPD patients with sleep disorders.
The approach is described as a possible beneficial adjunctive therapy.
The design is retrospective and observational, so findings are described as associations.
What This Means
This study looked at whether guided imagery training, a relaxation technique in which people are led to picture calming scenes or experiences, could help people with chronic obstructive pulmonary disease (COPD) sleep better. Researchers reviewed hospital records of patients with stable COPD and sleep problems. They compared those who received guided imagery in addition to usual medication with those who received medication alone, using a statistical matching method to make the two groups similar. In the end, 53 patients were compared in each group.
Both groups slept better after treatment. Sleep efficiency and the lowest blood oxygen level during sleep rose, while the time to fall asleep, the number of awakenings and breathing interruptions during sleep fell. Patients also reported better sleep on questionnaires. However, the group who also did guided imagery improved more than the medication-only group on all of these measures, including both sleep-lab measurements and questionnaire scores.
This research suggests guided imagery may be a useful add-on to standard treatment for sleep problems in people with COPD. Because the study looked back at existing records rather than randomly assigning patients to treatments, and was conducted at a single hospital, it can show an association but cannot prove that guided imagery caused the improvements. Larger prospective trials would help confirm the findings.
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Ren Q, Zhang H, Shi X, Ren L, Cheng J. (2026). Efficacy of Guided Imagery Training in Improving Sleep Quality in Patients With Chronic Obstructive Pulmonary Disease and Sleep Disorders.. Actas espanolas de psiquiatria. https://doi.org/10.62641/aep.2258