Efficient management of COPD patients should include a comprehensive sleep history, including sleep hygiene and OSA, according to a recent article titled “Update on obstructive sleep apnea and its relation to COPD” from Ohio State University researchers.
The article available via NIH update reiterated that chronic obstructive pulmonary disease (COPD) is a common and preventable lung disease that affects millions of people in the United States, while pointing out that many people with COPD also suffer from OSA, although it is a “complex relationship.”
“This relationship, however, puts people at risk for more nocturnal desaturations and potential complications related to this, including pulmonary hypertension and heart rhythm disturbances,” wrote researchers. “This update focuses on the physiology of sleep disturbances in COPD as well as the clinical implications of OSA in COPD.”
Nocturnal COPD symptoms have been reported in a significant number of patients, and may affect sleep, with Klink et al finding that nocturnal cough and wheezing resulted in 53% of the patients reporting difficulty initiating or maintaining sleep, and 23% reporting excessive daytime sleepiness.
“In addition, several studies have shown that sleep quality is worse in people with COPD compared to healthy individuals,” wrote researchers in the update. “Beyond symptoms, there are nocturnal alterations in ventilation and gas control in patients with COPD. The result for patients with significant daytime hypoxemia and hypercapnia may be more profound nocturnal changes in hypoxemia, especially during rapid eye movement (REM) sleep. In addition to increased nocturnal symptoms, poor sleep quality, and effects on gas exchange, there are a number of COPD patients who may also have comorbid obstructive sleep apnea (OSA).”