• Patients with chronic obstructive pulmonary disease frequently complain of sleep-related symptoms like unrefreshing sleep, insomnia, fatigue, and diurnal sleepiness.
• Studies during sleep show that in chronic obstructive pulmonary disease, patients’ oxyhemoglobin saturation is reduced from waking levels and sleep continuity is affected by frequent awakenings and apneic spells.

How can sleep disorders affect your respiratory system?

Sleep occupies up to one-third of every adult’s life, yet insufficient attention is given to the influence of sleep on medical disorders. This lack of awareness is unfortunate as sleep may have deleterious effects on many physiological and organ functions, which are frequently exacerbated in disease states. In the respiratory system, sleep has important effects on breathing and gas exchange that may exacerbate the dysfunction seen while awake in respiratory disorders such as COPD and asthma, among others. Furthermore, there are specific respiratory disorders associated with sleep such as obstructive sleep apnea (OSA), which may coexist with other chronic respiratory diseases and exacerbate sleep-related breathing disturbances.

What is overlap syndrome?

COPD and obstructive sleep apnea (OSA) are highly prevalent and different clinical COPD phenotypes influence the likelihood of comorbid OSA. The increased lung volumes and low body mass index (BMI) associated with the predominant emphysema phenotype protects against OSA whereas the peripheral edema and higher BMI often associated with the predominant chronic bronchitis phenotype promotes OSA. The diagnosis of OSA in COPD patients requires clinical awareness and screening questionnaires which may help identify patients for overnight study. Management of OSA-COPD overlap patients differs from COPD alone and the survival of overlap patients treated with nocturnal positive airway pressure is superior to those untreated.

When to do a sleep study?

The sleep diagnostic test aims to determine the degree of hypoxaemia and hypercapnia, the amount and type of breathing disorder (central/obstructive apnoea/hypoventilation) and the degree of sleep disturbance (such as REM sleep-associated hypoventilation). The choice of sleep study depends on local resources and specific diagnostic guidelines for COPD patients with suspected overlap or hypoventilation syndrome do not exist. Stable COPD patients with preserved sleep quality may be investigated with a home sleep study whereas patients with more complex sleep-related symptoms or an unstable COPD condition may need testing in a sleep laboratory.

Dr. Belinda Anet

Dr. Belinda Anet, a highly experienced Pulmonologist at Kauvery Hospital, Tirunelveli, is dedicated to providing comprehensive care for a range of respiratory conditions. With a special focus on COPD treatmentshe combines her expertise in lung health with a patient-centered approach to ensure personalized care for each individual.

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