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(Chest. 2000;117:48S-53S.)
© 2000 American College of Chest Physicians

Impact of Sleep in COPD*

Walter T. McNicholas, MD, FCCP

* From the Department of Respiratory Medicine, St. Vincent’s University Hospital, Dublin, Ireland.

Correspondence to: Walter T. McNicholas, MD, FCCP, Department of Respiratory, Medicine, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland

Sleep has well-recognized effects on breathing, including changes in central respiratory control, airways resistance, and muscular contractility, which do not have an adverse effect in healthy individuals but may cause problems in patients with COPD. Sleep-related hypoxemia and hypercapnia are well recognized in COPD and are most pronounced in rapid eye movement sleep. However, sleep studies are usually only indicated in patients with COPD when there is a possibility of sleep apnea or when cor pulmonale and/or polycythemia are not explained by the awake PaO2 level. Management options for patients with sleep-related respiratory failure include general measures such as optimizing therapy of the underlying condition; physiotherapy and prompt treatment of infective exacerbations; supplemental oxygen; pharmacologic treatments such as bronchodilators, particularly ipratropium bromide, theophylline, and almitrine; and noninvasive positive pressure ventilation.

Key Words: COPD • sleep




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