Abstract
Chronic obstructive pulmonary disease (COPD) prevalence is rising to epidemic proportions due to historical smoking trends, the aging of the population, and air pollution. Although blaming the victims has been common in COPD, the majority of COPD worldwide is now thought to be nonsmoking related, that is, caused by air pollution and cookstove exposure. It is increasingly appreciated that subjective and objective sleep disturbances are common in COPD, although strong epidemiological data are lacking. People with obstructive sleep apnea (OSA) plus COPD (the so-called overlap syndrome) have a high risk of cardiovascular death, although again mechanisms are unknown and untested. This review aims to draw attention to the problem of sleep in COPD, to encourage clinicians to ask their patients about symptoms, and to stimulate further research in this area given the large burden of the disease.
Highlights
Recent data suggest that roughly 10% of the population over the age of 40 years has clinically important chronic pulmonary obstructive pulmonary disease (COPD), with the majority of patients remaining undiagnosed and untreated [1]
Patients with COPD can experience profound desaturation instances during rapid eye movement (REM) sleep in part related to atonia in the skeletal muscles including the accessory muscles of respiration
Obstructive sleep apnea (OSA) as discussed below is a common disorder which can occur in COPD patients: the concurrence of these two conditions is known as overlap syndrome which is associated with a poor prognosis [3]
Summary
Recent data suggest that roughly 10% of the population over the age of 40 years has clinically important chronic pulmonary obstructive pulmonary disease (COPD), with the majority of patients remaining undiagnosed and untreated [1]. Sleep is a period of vulnerability for people with COPD for a number of reasons. The onset of sleep represents loss of the so-called “wakefulness drive to breathe” such that COPD patients can experience deterioration in gas exchange. Patients with COPD can experience profound desaturation instances during rapid eye movement (REM) sleep in part related to atonia in the skeletal muscles including the accessory muscles of respiration. Cough is typically suppressed during sleep such that people with COPD can develop mucus plugging and hypersecretion, affecting nocturnal gas exchange. Obstructive sleep apnea (OSA) as discussed below is a common disorder which can occur in COPD patients: the concurrence of these two conditions is known as overlap syndrome which is associated with a poor prognosis [3]. A strong physiological basis exists for why COPD patients have poor sleep quality
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
