OBJECTIVES: To assess quality of life (QoL) and dyspnea among chronic obstructive pulmonary disease (COPD) patients with/without nighttime (NT) and/or early morning (EM) symptoms. METHODS: This study was a cross-sectional patient survey. Administrative claims from the HealthCore Integrated Research Database were utilized to identify commercially-insured patients, aged ≥40 years, with ≥1 medical claim with an ICD-9-CM diagnosis code of COPD or ≥1 pharmacy claim for COPD maintenance medication between September 1, 2010-August 31, 2011. Consenting respondents completed a 25-minute survey that included screening questions classifying them as having NT/EM symptoms based on whether they experienced symptoms ≥3 nights/mornings in the past week. An attempt was made to maximize balance across groups with patients qualifying for closed groups being terminated. Patient-reported outcomes included the Short Form-12 version 2 (SF-12v2), the COPD Assessment Test (CAT), and the modified Medical Research Council (mMRC) dyspnea scale. Analysis of variance and chi-square were used to evaluate outcome differences among symptom groups. RESULTS: Of 752 respondents completing the survey, 42.3% reported having both NT/EM symptoms, 32.7% reported either NT or EM symptoms, and 25.0% reported neither symptoms. Mean (±SD) age was 60.2 (±8.0) years and the majority of respondents were female (60.5%), white (91.6%), and former/current smokers (87.1%). Compared to respondents without symptoms, those with both or either NT/EM symptoms reported worse QoL and dyspnea as indicated by significantly lower SF-12v2 Physical Component Summary (PCS) and Mental Component Summary (MCS) mean scores (PCS: 34.0 vs 38.6 vs 43.8, p<0.01; MCS: 47.0 vs 52.8 vs 54.3, p<0.01), as well as higher CAT and mMRC mean scores (CAT: 21.6 vs 13.8 vs 9.1, p<0.01; mMRC: 1.8 vs 1.1 vs 0.8, p<0.01). CONCLUSIONS: COPD patients with NT/EM symptoms reported worse QoL and dyspnea scores compared with patients without symptoms. Improved management of NT/EM symptoms may decrease the burden associated with these symptoms.