| Summary: | Background: Non-invasive ventilation (NIV) has been shown to be the most appropriate therapy for COPD patients with chronic respiratory failure. While physiological parameters and long-term outcome frequently serve as primary outcomes, very few studies have primarily addressed the impact of NIV initiation on sleep quality in COPD. Methods: This single-center prospective cohort study comprised NIV-naïve patients with COPD. All patients underwent polysomnographic evaluation both at baseline and at 3 months follow-up, accompanied by the assessment of health-related quality of life (HRQL) using the Severe Respiratory Insufficiency Questionnaire (SRI) and the Epworth Sleepiness Scale (ESS). A subgroup evaluation was performed to address the impact of comorbid obstructive sleep apnea syndrome (OSAS). Results: Forty-six patients were enrolled and twenty-five patients completed the follow-up period (66.7 ± 7.4 years). NIV resulted in an increase in slow-wave sleep (+2% (−3.5/7.5), <i>p</i> = 0.465) and rapid eye movement sleep (+2.2% (−1.0/5.4), <i>p</i> = 0.174), although no statistical significance could be detected. ESS (−1.7(−3.6/0.1), <i>p</i> = 0.066) also showed a positive trend. Significant improvements in the Respiratory Disturbance Index (RDI) (−12.6(−23.7/−1.5), <i>p</i> = 0.027), lung function parameters, transcutaneous PCO<sub>2</sub> and the SRI summary scale (4.5(0.9/8), <i>p</i> = 0.016) were observed. Conclusion: NIV therapy does not decrease sleep quality and is even capable of improving HRQL, transcutaneous PaCO<sub>2</sub>, daytime sleepiness and RDI, and the latter especially holds true for patients with comorbid OSAS.
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