[Sleep and COPD].
In COPD patients hypoxaemia does worsen during sleep and particularly during REM sleep. However, severe sleep-related O2 desaturation is only observed in patients who exhibit a marked daytime hypoxaemia. Nocturnal desaturation is due to the combination of alveolar hypoventilation and ventilation-perfusion mismatch; alveolar hypoventilation is the predominant mechanism, at least during REM sleep. Sleep-related hypoxaemia leads to peaks of pulmonary hypertension but also to cardiac arrhythmias. Hypoxaemia can be particularly severe when COPD is associated with a sleep apnoea syndrome (this association is rather frequent). A severe nocturnal desaturation needs a treatment with prolonged oxygen therapy, especially if daytime hypoxaemia (PaO2 < 55-60 mmHg) is present. The real benefit from oxygen therapy limited to sleep time in nocturnal desaturators who have not a significant daytime hypoxaemia, has not been yet demonstrated.
Weitzenblum
E
E
Service de pneumologie, Hôpital de Hautepierre, Strasbourg.
Chaouat
A
A
Charpentier
C
C
Krieger
J
J
D006801:Humans; D000860:Hypoxia / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology*
Sommeil et BPCO.