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Medical Management of Sleep in the COPD Patient

4 Steps to Better Sleep With COPD


Updated January 14, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Insomnia. Sleep apnea. Transient nocturnal desaturation. What do these terms have in common? They are each common sleep disturbances found in COPD that may leave you feeling frustrated, fatigued, and downright exhausted.

Sleep disturbances are well-recognized in people with COPD. Hypoxemia and hypercapnia may contribute to cor pulmonale, pulmonary hypertension, and even death during sleep.

If you are having trouble sleeping, it may be time to talk to your health care provider about medical management of your sleep problems. Here are some important guidelines, according to CHEST:

1. Optimize Treatment For Your Underlying Condition

One of the most important things you can do to manage sleep disturbance associated with COPD is to optimize treatment for your underlying condition. Not only will this have a beneficial effect on your COPD, but it will have a positive impact on your breathing as well.

2. Don't Forget Your Oxygen

In people with COPD, hypoxemia and hypercapnia are generally caused by a decrease in your breathing rate, also known as hypoventilation. When you sleep, you may have periods of breathing pauses (apnea)or desaturation that cause your oxygen levels to drop and your carbon dioxide levels to rise. Adding oxygen to the mix, particularly at night, plays an important role in managing oxygenation during sleep.

3. Consider Your Medications

Appropriate use of medications for your underlying condition, as well as for respiratory insufficiency during sleep, will help you get the best night's sleep possible. These include:

4. Think About Adding Non-Invasive Ventilation

Non-invasive positive pressure ventilation (NIPPV) is an alternative to mechanical ventilation for people with chronic respiratory insufficiency, particularly during sleep. Not only does NIPPV have beneficial effects on nighttime oxygen saturation levels, but it can improve daytime oxygen saturation as well. NIPPV may also increase respiratory muscle strength and endurance.


Walter T. McNicholas, MD, FCCP. Impact of Sleep in COPD. CHEST February 2000 vol. 117 no. 2 suppl 48S-53S.

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