If COPD symptoms keep you awake, try these sleep strategies for relief.

Chronic obstructive pulmonary disease (COPD) is characterized by abnormalities in the lungs that make it difficult to exhale normally. Generally, two conditions are involved: emphysema and chronic bronchitis.

Anywhere from one-third to one-half of all people with COPD have sleep disorders. Consequences of not getting enough sleep include a weakened immune system, which makes you more vulnerable to infection, and daytime sleepiness, which can prevent you from getting the exercise you need to help strengthen your heart and lungs.

Why is sleep so difficult?

Coughing, chest pain and medication side effects are sometimes to blame. Other conditions common in people with COPD, such as restless legs syndrome and gastroesophageal reflux disease (GERD), may also be a factor.

Oxygen levels are already low in people with COPD and drop even lower at night. Your brain responds by waking you up periodically to catch your breath—preventing you from entering the critical, restorative phases of deep sleep that you need.

Some people with COPD suffer from obstructive sleep apnea, a condition characterized by repeated episodes of interrupted breathing while sleeping. These interruptions lead to loud snoring, frequent awakenings and severe daytime sleepiness.

Your best bet for nailing down and addressing the exact cause of your sleep problem is to find a doctor who is knowledgeable about COPD and sleep issues. Sleep strategies you may try include:

  • Go to bed sleepy. You'll sleep more soundly if you’re truly tired at bedtime. Exercise may help, but talk to your doctor first about what kind of exercise and what level is best for you. Avoid napping during the daytime, and forego caffeinated beverages late in the day.
  • Be consistent in your sleep schedule. Maintain a regular sleep schedule by going to bed and waking up around the same time each day.
  • Adjust your medications. Talk to your doctor to make sure your inhalers and steroids are of sufficient dosage to get you through the night. If leg jerks or gastroesophageal reflux disease (GERD) keep you awake, you may need medication to treat those conditions.
  • Stay away from sleeping pills. Sleep aids—either prescription or over-thecounter—can be dangerous, since they slow breathing and reduce your response to stimuli while sleeping.
  • Add nighttime oxygen therapy. If your doctor determines that low blood oxygen levels contribute to your sleep problem, supplemental oxygen may help.
  • Use CPAP if you have obstructive sleep apnea. Continuous positive airway pressure (CPAP) devices deliver a steady stream of air through a nasal mask you wear overnight. If you chose not to use a CPAP device in the past because of their unwieldiness, note that CPAP technology has improved significantly over the past couple years.

If you have COPD, take your sleep problems seriously. If self-care measures don't work, see your doctor.

Doctor's Viewpoint

Hartmut Schneider, M.D., Ph.D., Assistant Professor of Pulmonary and Critical Care Medicine Johns Hopkins University Sleep Disorders Center

I strongly recommend using a CPAP device if you have COPD and obstructive sleep apnea. New technology has made CPAP devices less intrusive than they used to be, and they can make a big difference in your sleep quality. Because sleep deficiencies interfere with your ability to cope with your disease, it's critical to address what specifically is keeping you from getting the rest you need.

Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Publication Review By: the Editorial Staff at Healthcommunities.com

Published: 07 Jul 2013

Last Modified: 29 Aug 2013