Chest
Volume 91, Issue 1, January 1987, Pages 29-32
Journal home page for Chest

clinical investigations
The Effect of Sleep Loss on Breathing in Chronic Obstructive Pulmonary Disease

https://doi.org/10.1378/chest.91.1.29Get rights and content

We have previously shown that one night of sleep deprivation results in significant deterioration of spirometric performance and ventilatory responsiveness to inhaled carbon dioxide in normal people. Since even a small decrease in pulmonary function may be clinically important in patients with chronic limitation of airflow, we undertook the present study to assess the effects of sleep loss on breathing in patients with chronic obstructive pulmonary disease (COPD). Criteria for inclusion in this study were (1) a ratio of the forced expiratory volume in one second over the forced vital capacity (FEV1/FVC) of less than 60 percent, (2) no hospital admission for pulmonary disease within two weeks of testing, (3) stable (<30 percent variation) in tests of pulmonary function on two occasions within three months of testing, and (4) no history of asthma. We studied 15 men (mean age, 57 ±3 years) on two consecutive mornings. Patients were studied with and without sleep deprivation in a randomized fashion. Patients were hospitalized for the study so that sleep deprivation, medications, smoking, and diet could be monitored and enforced. We found small but statistically significant falls in FEV1 (1.06 ±0.11 to 1.00±0.09 L; p<0.05) and in FVC (2.56 ±0.20 to 2.43 ± 0.17 L; p<0.05) following sleep deprivation. Changes of similar magnitude which were not statistically significant occurred in maximal voluntary ventilation (MW) and response to carbon dioxide. The arterial oxygen (PaO2) and carbon dioxide (PaCO2) tensions were not affected. Maximal expiratory pressure at the mouth increased slightly, but there was a fall in maximal inspiratory pressure (MIP) at the mouth. We conclude that sleep loss is associated with small but significant falls in FEV1 and FVC, as well as changes of similar magnitude in MW, minute ventilation, and MIP in patients with severe COPD. Although the sleep loss which frequently accompanies exacerbations of COPD may be a slight additional stress of pulmonary reserve, a single night’s loss of sleep in the patient with stable chronic airflow obstruction does not have major clinical consequences.

Section snippets

Patient Population

We studied 15 patients, aged 52 to 65 years (mean, 57 ±3 years), with the clinical diagnosis of COPD (mean forced expiratory volume in one second [FEV1], 1.06 ±0.41 L). Requirements for the study were (1) ratio of FEV1 over forced vital capacity (FVC) of less than 60 percent, (2) no episode of decompensated pulmonary disease within two weeks of testing, (3) stable (<30 percent variation) tests of pulmonary function on two separate occasions within three months of testing, and (4) no history of

REFERENCES (20)

There are more references available in the full text version of this article.

Cited by (84)

  • Sleep loss associated with medical conditions and diseases

    2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second Edition
  • Effectiveness of complementary and alternative medicine interventions for sleep quality in adult intensive care patients: A systematic review

    2020, International Journal of Nursing Studies
    Citation Excerpt :

    A review of studies investigating sleep disturbance in ICU patients found this included changed circadian rhythm, poor sleep quality, and frequent interruption and wakening with a lack of deeper non-REM sleep and REM sleep (Boyko et al., 2012; Kamdar et al., 2012). Consequences of sleep deprivation particularly relevant to ICU patients include, but are not limited to, increased pain sensitivity (Figueroa-Ramos et al., 2009; Lautenbacher et al., 2006; Onen et al., 2001), reduced respiratory capacity (Figueroa-Ramos et al., 2009; Phillips et al., 1987), impaired immunity (Figueroa-Ramos et al., 2009; Phillips et al., 1987), and changes in neuroendocrine and metabolic functions (Figueroa-Ramos et al., 2009; Van Cauter et al., 2007). Additionally, psychological consequences of sleep deprivation include memory and mood deficits (Carlson, 2012; Figueroa-Ramos et al., 2009).

  • Sleep in Hospitalized Patients

    2019, Handbook of Sleep Disorders in Medical Conditions
View all citing articles on Scopus

Supported by a grant from the Kentucky Lung Association

View full text