Sleep in Chronic Obstructive Pulmonary Disease

Vahid Mohsenin

doi:10.1055/s-2005-864204

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2005; 26(1): 109-116
DOI: 10.1055/s-2005-864204

Sleep in Chronic Obstructive Pulmonary Disease

Vahid Mohsenin¹ ^, ²

¹Yale University School of Medicine, New Haven, Connecticut
²Yale Center for Sleep Medicine, New Haven, Connecticut

Abstract

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death, affecting 14 million adults in the United States. Symptoms related to sleep disturbances are common in moderate to severe COPD, particularly in elderly patients, in the form of morning tiredness and early awakenings. One major cause of morbidity in this population is abnormalities in gas exchange and resultant hypoxemia. Sleep has profound adverse effects on respiration and gas exchange in patients with COPD. There are several mechanisms underlying nonapneic oxygen desaturation during sleep. They include decreased functional residual capacity, diminished ventilatory responses to hypoxia and hypercapnia, impaired respiratory mechanical effectiveness, diminished arousal responses, respiratory muscle fatigue, diminished nonchemical respiratory drive, increased upper airway resistance, and the position of baseline saturation values on the oxyhemoglobin dissociation curve. Smoking cessation, bronchodilation, and pulmonary rehabilitation are cornerstones of treatment of COPD. Improvement in lung mechanics and gas exchange should lead to better sleep quality and health status.

KEYWORDS

Gas exchange - hypoxemia - sleep

Full Text

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Vahid MohseninM.D.

Yale Center for Sleep Medicine, Yale University School of Medicine

40 Temple St., Ste. 3C, New Haven, CT 06510

Email: vahid.Mohsenin@yale.edu