| Sumario: | Background: Sleep-related disorders are common among older adults with chronic obstructive pulmonary disease (COPD). Breathing exercises, a key component of pulmonary rehabilitation programs, may improve sleep quality. However, there is a paucity of research on the impact of breathing exercises on sleep quality in elderly patients with COPD. Objective: This study aimed to compare the effects of diaphragmatic breathing (DB) and pursed-lip breathing (PLB) exercises on sleep quality in elderly patients with COPD. Design: Crossover clinical trial. Methods: In this study, 60 elderly patients with COPD were randomly assigned to two groups: DB followed by PLB (Group 1) and PLB followed by DB (Group 2). Each exercise was performed for 4 weeks. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Abbreviated Mental Test Score (AMTS), and COPD Assessment Test (CAT) questionnaires before training. Data were analyzed using descriptive and inferential statistics in SPSS version 21, with a significance level of 0.05. Results: Both DB and PLB exercises significantly improved sleep quality in elderly patients with COPD (P < 0.05). No significant difference was found between the two exercises. However, the sequence of exercises in Group 1 (DB followed by PLB) resulted in greater improvement in average sleep quality compared to Group 2. Conclusion: This study demonstrates that DB and PLB exercises enhance sleep quality in elderly patients with COPD. These exercises are recommended as an effective non-pharmacological approach to improve sleep quality in this population. Plain Language Summary: Comparison of the Effects Breathing Exercises on the Sleep Quality of Elderly Patients with Chronic Obstructive Pulmonary Disease Background: Sleep-related disorders are common in older adults with chronic obstructive pulmonary disease. The breathing exercises gives some benefits to these patients. However, the literature attests to the scarcity of research on the impact of breathing exercises on sleep quality among elderly patients. This study aimed to determine the impact of breathing exercises on the sleep quality among elderly patients with chronic obstructive pulmonary disease in Guilan, the north of Iran. Methods: In this study, a total of 60 elderly patients were assigned to two groups (group 1: 4 weeks of abdominal (diaphragmatic) breathing followed by 4 weeks of tightly pressed (pursed) lips breathing exercises; group 2: 4 weeks of tightly pressed lips breathing exercises followed by 4 weeks of abdominal breathing). After completing demographic information and questionnaires, training was conducted on how to perform breathing exercises. Results: Both abdominal and tightly pressed lips breathing exercises individually had an effect on the sleep quality of elderly patients with chronic obstructive pulmonary disease. However, there was no difference in the impact on sleep quality between the two types of breathing exercises. Nevertheless, the arrangement of the breathing exercises in the first group, starting with 4 weeks of abdominal breathing followed by 4 weeks of tightly pressed lips breathing exercises, led to a greater improvement in sleep quality of these patients compared to the arrangement in the second group. Conclusion: The results of this study indicated that abdominal and tightly pressed lips breathing exercises improve the sleep quality of older adults with chronic obstructive pulmonary disease.
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