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NCT Number: NCT07799896

The Impact of Indoor Environmental Quality on Symptoms in Patients With Chronic Obstructive Pulmonary Disease

This prospective, monocenter pilot study will investigate the relationship between indoor environmental quality (including air quality, lighting, noise, and thermal conditions), wearable-derived health insights, and patient-reported symptoms in patients recovering at home after hospitalization for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Participants will undergo continuous monitoring of indoor environmental conditions and health parameters using a Garmin Venu 4 smartwatch, together with validated questionnaires assessing COPD symptoms, sleep quality, and daytime sleepiness during one month. The study will assess the feasibility and potential added value of high-resolution home monitoring and explore whether environmental and wearable-derived measures are associated with symptom burden and early signs of clinical deterioration following hospital discharge.

The investigators hypothesize that continuous in-home monitoring of indoor environmental quality is feasible and provides clinically relevant insights into symptom burden in recently hospitalized COPD patients. The primary objective is to determine the correlation between indoor environmental quality (IEQ) variables and symptom burden in COPD patients following hospitalization for AECOPD.

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Key information

Conditions

COPD (Chronic Obstructive Pulmonary Disease) Acute Exacerbation of COPD Chronic Disease Disease Attributes Lung Diseases Lung Diseases, Obstructive Pathologic Processes Pathological Conditions, Signs and Symptoms Pulmonary Disease, Chronic Obstructive Respiratory Tract Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Patients hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remain highly vulnerable after discharge, with persistent symptom burden and an increased risk of early recurrent exacerbations. During this post-hospitalization period, patients spend most of their time indoors, making indoor environmental quality (IEQ, including air quality, lighting, noise and thermal aspects) a potentially important and modifiable determinant of recovery. For example, exposure to particulate matter (PM) has been associated with airway inflammation, symptom worsening, and increased exacerbation risk in COPD. However, evidence on continuously measured IEQ at home and its relationship with symptoms after hospitalization for acute exacerbation of COPD remains limited.

Recent advances in wearable technology allow continuous monitoring of health insights in real-world settings. Prior studies have demonstrated the feasibility of wearable devices in patients with COPD and suggest that changes in activity, heart rate, and sleep may precede clinical deterioration or exacerbations. Integrating continuous IEQ monitoring with wearable-derived health insights (i.e., from a Garmin Venu 4 watch) and validated patient-reported outcomes, such as the widely used COPD Assessment Test (CAT), Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), Sleep Quality Scale (SQS), may improve understanding of symptom dynamics, uncover risk factors, and identify early indicators of worsening disease. This prospective monocenter pilot study aims to explore these relationships and to assess the feasibility and added value of high-resolution IEQ monitoring in the home setting of recently hospitalized COPD patients.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Provide signed and dated informed consent
  • Adults older than 18 years of age
  • Previously diagnosed with COPD according to GOLD guidelines
  • Hospitalization due to AECOPD
  • Spend >50% of time indoor at home
  • Speak and understand the Dutch language

Exclusion criteria

  • Previous diagnosis of asthma
  • (History of) chronic macrolide use (> 3 months)
  • Living in institution or residential care center
  • Estimated life expectancy of less than 6 months
  • Not in the possession of a smartphone

Treatment and study plan

Wearable mobile device

Device

Patients admitted due to an acute COPD exacerbation will be asked to wear the wearable mobile device for a period of one month after hospital discharge. An app linked to the device will be installed on their phone, and used to send health insights to the investigators.

Other names: Garmin Venu

Indoor environmental quality sensor

Device

When the participants are discharged home, an indoor environmental quality sensor will be installed in the patient's home. One sensor will be installed in the bedroom, one in the living room or kitchen (wherever the patient spends the most time). Data from these sensors will be sent to the hub (placed central between the sensors) and thereafter, to the investigators. The sensors measure particulate matter concentrations, CO2 concentrations, VOC concentrations, temperature, relative humidity, ambient light, and ambient noise.

CAT Questionnaire

Other

A COPD Assessment Test questionnaire will be taken during the hospitalization (start of the study), and weekly after discharge.

PSQI Questionnaire

Other

A Pittsburgh Sleep Quality Index questionnaire will be taken 4 weeks after hospital discharge (end of the study).

KSS Questionnaire

Other

A Karolinska Sleepiness Scale questionnaire will be taken daily after discharge.

SQS Questionnaire

Other

A sleep quality scale questionnaire will be taken daily after discharge.

PROMs Questionnaire

Other

A PROMs questionnaire will be taken daily after discharge.

eHLQ Questionnaire

Other

An eHealth literacy questionnaire will be taken during the hospitalization (start of the study), and 4 weeks after hospital discharge (end of the study).

Housing Questionnaire

Other

A housing questionnaire will be taken during the hospitalization (start of the study).

Primary outcomes

  1. Weekly score of COPD symptom burden assessed using the COPD Assessment Test (CAT)

    Time frame: Baseline and weekly during the 1-month follow-up

    COPD symptom burden will be assessed using the COPD Assessment Test (CAT). The CAT is an 8-item questionnaire with a total score ranging from 0 to 40 points, with higher scores indicating greater COPD symptom burden and a greater impact of COPD on daily life.

  2. Weekly mean PM0.5 concentration

    Time frame: Weekly during the 1-month follow-up

    Indoor PM0.5 concentration (µg/m³) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean PM0.5 concentration.

  3. Weekly mean PM2.5 concentration

    Time frame: Weekly during the 1-month follow-up

    Indoor PM2.5 concentration (µg/m³) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean PM2.5 concentration.

  4. Weekly mean PM4 concentration

    Time frame: Weekly during the 1-month follow-up

    Indoor PM4 concentration (µg/m³) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean PM4 concentration.

  5. Weekly mean PM10 concentration

    Time frame: Weekly during the 1-month follow-up

    Indoor PM10 concentration (µg/m³) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean PM10 concentration.

  6. Weekly mean CO2 concentration

    Time frame: Weekly during the 1-month follow-up

    Indoor CO2 concentration (ppm) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean CO2 concentration.

  7. Weekly mean VOC concentration

    Time frame: Weekly during the 1-month follow-up

    Indoor volatile organic compound (VOC) concentration (ppb) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean VOC concentration.

  8. Weekly mean temperature

    Time frame: Weekly during the 1-month follow-up

    Indoor temperature concentration (°C) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean temperature.

  9. Weekly mean relative humidity

    Time frame: Weekly during the 1-month follow-up

    Indoor relative humidity (%) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week will be aggregated to calculate a weekly mean relative humidity.

  10. Weekly mean ambient light - day

    Time frame: Weekly during the 1-month follow-up

    Indoor ambient light (lux) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week during day-time hours will be aggregated to calculate a weekly mean ambient light - day.

  11. Weekly mean ambient light - night

    Time frame: Weekly during the 1-month follow-up

    Indoor ambient light (lux) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week during night-time hours will be aggregated to calculate a weekly mean ambient light - night.

  12. Weekly mean ambient noise - night

    Time frame: Weekly during the 1-month follow-up

    Indoor ambient noise (dB) will be measured at 15-minute intervals in the participant's home during the 1-month follow-up. The measurements collected during each week during night-time hours will be aggregated to calculate a weekly mean ambient noise - night.

  13. Weekly overall proportion of time with at least one IEQ threshold violated

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which at least one predefined indoor environmental quality (IEQ) threshold is violated. IEQ variables will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, the IEQ variables will be compared with their respective predefined thresholds. The proportion of monitoring time points at which at least one IEQ threshold is violated will be calculated for each week.

Secondary outcomes

  1. Feasibility - Measurement completeness

    Time frame: During follow-up (1 month)

    Proportion of expected IEQ measurements successfully recorded.

  2. Feasibility - Valid monitoring time

    Time frame: During follow-up (1 month)

    Duration of valid monitoring time per participant.

  3. Daily perceived change in health status

    Time frame: Daily during follow-up (1 month)

    Patient-reported change in overall health status compared with the previous day, assessed using a single question: "How is your health today compared with yesterday?" Participants will select one of three response options: better, about the same, or worse.

  4. Feasibility - Frequency of data gaps

    Time frame: During follow-up (1 month)

    Frequency of gaps in monitoring data.

  5. Feasibility - Duration of data gaps

    Time frame: During follow-up (1 month)

    Duration of gaps in monitoring data.

  6. Wearable-derived health insights - Heart rate

    Time frame: Continuous monitoring during follow-up (1 month)

    Heart rate (BPM) measured using the wearable.

  7. Wearable-derived health insights - Respiratory rate

    Time frame: Continuous monitoring during follow-up (1 month)

    Respiratory rate (BPM) measured using the wearable.

  8. Wearable-derived health insights - Oxygen saturation

    Time frame: Continuous monitoring during follow-up (1 month)

    Oxygen saturation (%) measured using the wearable.

  9. Wearable-derived health insights - Skin temperature

    Time frame: Continuous monitoring during follow-up (1 month)

    Nightly deviation in skin temperature (°C) compared with the previous night, measured using the wearable.

  10. Sleep quality - PSQI

    Time frame: End of study (one month)

    Pittsburgh Sleep Quality Index (PSQI) assessing subjective sleep quality over the preceding month. The PSQI total score ranges from 0 to 21 points, with higher scores indicating poorer sleep quality.

  11. Sleepiness - KSS

    Time frame: Daily during the 1-month follow-up

    Karolinska Sleepiness Scale (KSS) assessing subjective sleepiness at a specific time point. The KSS score ranges from 1 to 9 points, with higher scores indicating greater subjective sleepiness.

  12. Sleep quality - SQS

    Time frame: Daily during the 1-month follow-up

    Single-item Sleep Quality Scale (SQS) assessing perceived sleep quality of the previous night. The SQS score ranges from 0 to 10 points, with higher scores indicating better perceived sleep quality.

  13. Wearable-derived sleep metrics - Sleep duration

    Time frame: Nightly during the 1-month follow-up

    Nightly sleep duration (hours) measured using the wearable.

  14. Wearable-derived sleep metrics - Sleep score

    Time frame: Nightly during the 1-month follow-up

    Nightly sleep score measured using the wearable. Score from 0-100, with a higher score indicating better quality of sleep.

  15. Wearable-derived sleep metrics - Time in sleep cycle

    Time frame: Nightly during the 1-month follow-up

    Nightly time spent in REM, deep, and light sleep (hours).

  16. Wearable-derived physical activity - Daily step count

    Time frame: Daily during the 1-month follow-up

    Daily step count (number) measured by the wearable.

  17. Wearable-derived physical activity - Activity minutes

    Time frame: Daily during the 1-month follow-up

    Daily activity minutes (minutes) measured by the wearable.

  18. Concentration of outside air quality

    Time frame: During follow-up (1 month)

    Concentration of outside air quality measure (PM, expressed in µg/m³) based on the participant's residential area.

  19. COPD exacerbations

    Time frame: During follow-up (1 month)

    Occurrence of a COPD exacerbation during the follow-up period.

  20. eHealth literacy

    Time frame: Baseline and end of study (one month)

    eHealth Literacy Questionnaire (eHLQ) domain scores describing participants' strengths and needs related to eHealth literacy. The eHLQ consists of 35 items across 7 domains. Each domain is scored from 1 to 4 points, with higher scores indicating a greater level of the characteristic assessed by the respective domain.

  21. Change in eHealth literacy

    Time frame: Baseline and end of study (one month)

    Change in eHealth literacy from baseline to the end of the 1-month follow-up, assessed using the eHealth Literacy Questionnaire (eHLQ). The eHLQ consists of 35 items across 7 domains. Each domain is scored from 1 to 4 points. Higher scores indicate a greater level of the characteristic assessed by the respective domain. Change in each domain score from baseline to 1 month will be calculated.

  22. Housing characteristics

    Time frame: Baseline

    Sociodemographic characteristics, housing characteristics, and indoor environmental factors assessed using the Housing Conditions Questionnaire.

  23. Weekly overall proportion of time with PM0.5 threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which PM0.5 threshold is exceeded. PM0.5 will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, PM0.5 will be compared with its respective predefined threshold. The proportion of monitoring time points at which PM0.5 is exceeded will be calculated for each week.

  24. Weekly overall proportion of time with PM1 threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which PM1 threshold is exceeded. PM1 will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, PM1 will be compared with its respective predefined threshold. The proportion of monitoring time points at which PM1 is exceeded will be calculated for each week.

  25. Weekly overall proportion of time with PM2.5 threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which PM2.5 threshold is exceeded. PM2.5 will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, PM2.5 will be compared with its respective predefined threshold. The proportion of monitoring time points at which PM2.5 is exceeded will be calculated for each week.

  26. Weekly overall proportion of time with PM4 threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which PM4 threshold is exceeded. PM4 will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, PM4 will be compared with its respective predefined threshold. The proportion of monitoring time points at which PM4 is exceeded will be calculated for each week.

  27. Weekly overall proportion of time with PM10 threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which PM10 threshold is exceeded. PM10 will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, PM10 will be compared with its respective predefined threshold. The proportion of monitoring time points at which PM10 is exceeded will be calculated for each week.

  28. Weekly overall proportion of time with CO2 threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which the CO2 threshold is exceeded. CO2 will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, CO2 will be compared with its respective predefined threshold. The proportion of monitoring time points at which CO2 is exceeded will be calculated for each week.

  29. Weekly overall proportion of time with VOC threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which the VOC threshold is exceeded. VOC will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, VOC will be compared with its respective predefined threshold. The proportion of monitoring time points at which VOC is exceeded will be calculated for each week.

  30. Weekly overall proportion of time with temperature threshold violated

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which the temperature threshold is violated. The temperature will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, the temperature will be compared with its respective predefined threshold. The proportion of monitoring time points at which the temperature is violated will be calculated for each week.

  31. Weekly overall proportion of time with the relative humidity threshold violated

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which the relative humidity threshold is violated. The relative humidity will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, the relative humidity will be compared with its respective predefined threshold. The proportion of monitoring time points at which the relative humidity is violated will be calculated for each week.

  32. Weekly overall proportion of time with ambient light (day) threshold violated

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which the ambient light threshold is violated during the day-time hours. The ambient light will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, ambient light will be compared with its respective predefined threshold. The proportion of monitoring time points at which ambient light is violated during the day-time hours will be calculated for each week.

  33. Weekly overall proportion of time with ambient light (night) threshold violated

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which the ambient light threshold is violated during the night-time hours. The ambient light will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, ambient light will be compared with its respective predefined threshold. The proportion of monitoring time points at which ambient light is violated during the night-time hours will be calculated for each week.

  34. Weekly overall proportion of time with the ambient noise (night) threshold exceeded

    Time frame: Weekly during the 1-month follow-up

    Overall proportion of monitoring time per week during which the ambient noise threshold is exceeded during night-time hours. The ambient noise will be monitored at predefined measurement intervals during the 1-month follow-up. For each measurement time point, the ambient noise will be compared with its respective predefined threshold. The proportion of monitoring time points at which ambient noise is exceeded during night-time hours will be calculated for each week.

Study contacts

Contact information is provided by the study sponsor or research team.

Femke Wouters, PhD

CONTACT

[email protected]

Ruben Knevels, MsC

CONTACT

[email protected]

+3289804029

Sponsors and collaborators

Lead sponsor

Ziekenhuis Oost-Limburg

Other

Collaborators

  • Hasselt University
  • KU Leuven
  • Maastricht University
  • University of Liege

Registry information

Official study title

The Impact of Indoor Environmental Quality on Symptoms in Patients With Chronic Obstructive Pulmonary Disease: A Prospective Pilot Study

Acronym: COPD-AIR

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Sep 2, 2026
Registry last updated
Sep 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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