PT  - JOURNAL ARTICLE
AU  - McNicholas, Walter T.
AU  - Hansson, Daniel
AU  - Schiza, Sofia
AU  - Grote, Ludger
TI  - Sleep in chronic respiratory disease: COPD and hypoventilation disorders
AID  - 10.1183/16000617.0064-2019
DP  - 2019 Sep 30
TA  - European Respiratory Review
PG  - 190064
VI  - 28
IP  - 153
4099  - https://publications.ersnet.org//content/28/153/190064.short
4100  - https://publications.ersnet.org//content/28/153/190064.full
SO  - EUROPEAN RESPIRATORY REVIEW2019 Sep 30; 28
AB  - COPD and obstructive sleep apnoea (OSA) are highly prevalent and different clinical COPD phenotypes that 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 oedema and higher BMI often associated with the predominant chronic bronchitis phenotype promote 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. Sleep-related hypoventilation is common in neuromuscular disease and skeletal disorders because of the effects of normal sleep on ventilation and additional challenges imposed by the underlying disorders. Hypoventilation is first seen during rapid eye movement (REM) sleep before progressing to involve non-REM sleep and wakefulness. Clinical presentation is nonspecific and daytime respiratory function measures poorly predict nocturnal hypoventilation. Monitoring of respiration and carbon dioxide levels during sleep should be incorporated in the evaluation of high-risk patient populations and treatment with noninvasive ventilation improves outcomes.Sleep disordered breathing disorders, such as obstructive sleep apnoea, are common in patients with chronic respiratory diseases. Diagnosis is often challenging, but treatment options seem to improve outcomes. http://bit.ly/2LaJMlf