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Sleep in chronic respiratory disease: COPD and hypoventilation disorders

Artikel i vetenskaplig tidskrift
Författare W. T. McNicholas
Hansson Daniel
S. Schiza
Ludger Grote
Publicerad i European Respiratory Review
Volym 28
Nummer/häfte 153
ISSN 0905-9180
Publiceringsår 2019
Publicerad vid Institutionen för medicin
Språk en
Länkar dx.doi.org/10.1183/16000617.0064-20...
Ämnesord obstructive pulmonary-disease, positive-pressure ventilation, quality-of-life, noninvasive ventilation, nocturnal hypoventilation, american academy, oxygen-therapy, apnea syndrome, mechanical, ventilation, neuromuscular disease, Respiratory System
Ämneskategorier Klinisk medicin

Sammanfattning

COPD and obstructive sleep apnoea (OSA) are highly prevalent and different clinical (DPD 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.

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