title: Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management.
abstract: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be complicated by sleep disorders. Insomnia and obstructive sleep apnea are commonly encountered in patients with COPD. Nocturnal hypoxemia is also prevalent in COPD may occur despite adequate awake oxygenation and can be especially severe in rapid eye movement sleep. Additionally, several factors--some of them unique to COPD--can contribute to sleep-related hypoventilation. Recognition of hypoventilation can be vital as supplemental oxygen therapy itself can acutely worsen hypoventilation and lead to disastrous consequences. Finally, accruing data establish an association between restless leg syndrome and COPD--an association that may be driven by hypoxemia and/or hypercapnia. Comorbid sleep disorders portend worse sleep quality, diminished quality of life, and multifarious other adverse consequences. The awareness and knowledge regarding sleep comorbidities in COPD has continued to evolve over past many years. There are still several lacunae, however, in our understanding of the etiologies, impact, and therapies of sleep disorders, specifically in patients with COPD. This review summarizes the latest concepts in prevalence, pathogenesis, diagnosis, and management of diverse sleep disorders in COPD.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Tufts Medical Center, Boston, MA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Budhiraja
authors.affiliation: Division of Allergy, Critical Care, Pulmonary and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ.
authors.forename: Tauseef A
authors.initials: TA
authors.lastname: Siddiqi
authors.affiliation: Division of Allergy, Critical Care, Pulmonary and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ.|Divisions of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Stuart F
authors.initials: SF
authors.lastname: Quan
mesh_terms: D006801:Humans; D000860:Hypoxia / Q000209:etiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012148:Restless Legs Syndrome / Q000209:etiology / Q000628:therapy; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000628:therapy; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000628:therapy; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000628:therapy