Elsevier

Respiratory Medicine

Volume 102, Issue 6, June 2008, Pages 801-814
Respiratory Medicine

Review
Sleep, hypnotics and chronic obstructive pulmonary disease

https://doi.org/10.1016/j.rmed.2007.12.026Get rights and content
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Summary

The quality of sleep is significantly compromised in many patients with chronic obstructive pulmonary disease (COPD) and may be further diminished when certain comorbidities are present. A reduced sleep quality is associated with daytime consequences like fatigue, psychiatric problems and an impaired quality of life.

Sleep induces physiologic alterations in respiratory function, which can become pathologic and may provoke or worsen hypoxemia and hypercapnia in COPD. Dyspnea, cough and excessive mucus production should be optimised to minimise causes for sleep disturbance. Pharmacological therapy may be helpful; sedatives like benzodiazepines and non-benzodiazepine benzodiazepine-receptor agonists (NBBRAs) are (equally) effective in improving sleep quality. Whether or not these hypnotics produce serious adverse respiratory effects during sleep, remains unclear due to opposing studies. Therefore, their use should be as short as possible.

Abbreviation

COPD
chronic obstructive pulmonary disease
DIMS
difficulties initiating and/or maintaining sleep
EDS
excessive daytime sleepiness
FEV1
forced expiratory volume in 1 s
FRC
functional residual capacity
FVC
forced vital capacity
GABA
gamma-aminobutyric acid
HCVR
hypercapnic ventilatory response
HVR
hypoxic ventilatory response
NBBRA
non-benzodiazepine benzodiazepine-receptor agonist
OSAS
obstructive sleep apnoea syndrome
PCO2
partial pressure of carbon dioxide
PO2
partial pressure of oxygen
REM
rapid eye movement
SaO2
oxygen saturation
TST
total sleep time
Ve
minute ventilation
Vi
inspired minute ventilation
V/Q
ventilation/perfusion relationships

Keywords

Benzodiazepines
Breathing
Hypnotics
Non-benzodiazepine benzodiazepine-receptor agonist
Pulmonary disease
Chronic obstructive

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