For people with chronic obstructive pulmonary disease, getting good sleep is vital. But doctors don't always pay enough attention to lack of sleep as a symptom of worsening COPD. A study published in 2013 found that 78 percent of patients with chronic obstructive pulmonary disease (COPD) reported at least one of the following sleep disturbances:
- Trouble falling asleep
- Trouble staying asleep
- Waking several times per night
- Waking up feeling tired and worn out
These sleep disturbances can worsen COPD symptoms; researchers found them linked to more exacerbations and daytime breathlessness, and the need for more maintenance therapy than those who didn't experience such disturbances. However, the same study found that physicians appeared to significantly underestimate the impact of COPD on the ability of patients to sleep well and get up in the morning.
Another study, using the national registries of people in Iceland and Sweden, found strong associations between restless leg syndrome (a common symptom of sleep disorders) and smoking and respiratory symptoms that disturb sleep and detract from quality of life.
Why is COPD linked with sleep issues?
One theory suggests inflammation may be at least partly to blame, with a 2016 study finding increased levels of IL-6 (an inflammatory messenger) in both men and women with COPD.
It is worth noting, however, that although there are studies that have demonstrated higher levels of inflammation in COPD patients, the association between sleep disturbances, COPD, and inflammation has not been thoroughly investigated.
Common issues associated with COPD such as heart disease, obesity, and a lack of exercise have also been linked to sleep disturbances.
The symptoms of COPD have a huge impact on quality of life, with the burden being compared to those of cancer sufferers, only people with COPD tend to live longer, suffering more.
Improving sleep could go some way towards relieving the burden of COPD symptoms, and alleviating COPD symptoms may help improve sleep.
- Chest tightness
- Difficulty breathing
Researchers at Emory University's Division of Pulmonary, Allergy, Critical Care and Sleep Medicine in Atlanta concluded in a 2015 report that diagnosing sleep abnormalities in patients with COPD is important not only to improve quality of life, but to prevent conditions that can lead to heart attacks and even death. The report also suggested that insomnia symptoms, such as difficulty falling asleep and staying asleep, may be down to the use of certain COPD medications.
Sleep issues should never be ignored, yet individuals with COPD should address them with particular urgency.
In one study, two-thirds of COPD patients tested positive for obstructive sleep apnea.
When obstructive sleep apnea exists with COPD (sometimes referred to as overlap syndrome), it can exacerbate, and even increase mortality risk.
ow to address sleep issues associated with COP
CPAP therapy is usually considered to be the best treatment for obstructive sleep apnea, however as COPD progresses, the addition of supplemental oxygen and/or non-invasive positive pressure ventilation (NPPV) may be helpful.
Choosing the right sleeping position is important; sleeping on your back can increase airway resistance.
Having a healthy diet can help tackle obesity, which is a known contributor to sleep disturbances.
Exercise training (after consultation with a healthcare professional) can mitigate the symptoms of COPD and can also improve sleep.
Practicing good sleep hygiene can also help.
And finally, cognitive behavioral therapy can address and correct the thoughts and behaviors that harm sleep.
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Martin is the creator of Insomnia Land’s free sleep training for insomnia. His online course uses CBT techniques to teach participants how to sleep without relying on sleeping pills. More than 4,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend.