Zusammenfassung
Die chronisch-obstruktive Lungenerkrankung (COPD) ist eine Erkrankung mit einer hohen Prävalenz. Der Schlaf spielt eine wichtige Rolle für diese Erkrankung. Veränderungen der Atmung und der Lungenfunktion im Schlaf können bei der COPD zu nächtlicher Hypoventilation führen. Zudem besteht eine erhöhte Prävalenz einer obstruktiven Schlafapnoe. Schließlich kann eine COPD über vielfältige Mechanismen zur Entstehung einer Insomnie beitragen. Dieser Artikel versucht die komplexen Zusammenhänge zwischen dieser Erkrankung und dem Schlaf aus pathophysiologischer Sicht zu beleuchten und Konsequenzen für Diagnostik und Therapie aufzuzeigen.
Abstract
Chronic obstructive pulmonary disease (COPD) is a disease affecting millions of people around the world. Sleep may play an important role in this disease. Circadian variations of ventilation and pulmonary function may cause hypoventilation during the night in COPD patients. Obstructive sleep apnea is also prevalent in COPD patients. In addition, many factors can lead to insomnia in patients with COPD. This article focuses on the complex interaction between COPD and sleep and illustrates the consequences for diagnostic procedures and treatment.
Literatur
Agusti AG, Sauleda J, Miralles C et al (2002) Skeletal muscle apoptosis and weight loss in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 166:485–489
Biselli P, Grossman PR, Kirkness JP et al (2015) The effect of increased lung volume in chronic obstructive pulmonary disease on upper airway obstruction during sleep. J Appl Physiol 119:266–271
Budhiraja R, Parthasarathy S, Budhiraja P et al (2012) Insomnia in patients with COPD. Sleep 35:369–375
Budweiser S, Jörres RA, Pfeifer M (2008) Noninvasive home ventilation for chronic obstructive pulmonary disease: indications, utility and outcome. Curr Opin Pulm Med 14:128–134
Casanova C, Celli BR, Tost L et al (2000) Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD. Chest 118:1582–1590
Chaouat A, Weitzenblum E, Kessler R et al (1997) Sleep-related O2 desaturation and daytime pulmonary haemodynamics in COPD patients with mild hypoxaemia. Eur Respir J 10:1730–1735
Clini E, Sturani C, Rossi A et al (2002) The Italian multicentre study on noninvasive ventilation in chronic obstructive pulmonary disease patients. Eur Respir J 20:529–538
Cormick W, Olson LG, Hensley MJ et al (1986) Nocturnal hypoxaemia and quality of sleep in patients with chronic obstructive lung disease. Thorax 41:846–854
Dempsey JA, Veasey SC, Morgan BJ et al (2010) Pathophysiology of sleep apnea. Physiol Rev 90:47–112
Deutsche Gesellschaft für Pneumologie (2001) Leitlinie zur Sauerstofftherapie. Pneumologie 55:454–464
Douglas NJ, White DP, Pickett CK et al (1982) Respiration during sleep in normal man. Thorax 37:840–844
Douglas NJ, White DP, Weil JV et al (1982) Hypercapnic ventilatory response in sleeping adults. Am Rev Respir Dis 126:758–762
Flenley DC (1985) Sleep in chronic obstructive lung disease. Clin Chest Med 6:651–661
Gay PC, Hubmayr RD, Stroetz RW (1996) Efficacy of nocturnal nasal ventilation in stable,severe chronic obstructive pulmonary disease during a 3-month controlled trial. Mayo Clin Proc 71:533–542
Kim HC, Mofarrahi M, Hussain SN (2008) Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 3:637–658
Köhnlein T, Windisch W, Köhler D et al (2014) Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicenter,randomized, controlled clinical trial. Lancet Respir Med 2:698–705
Kolodziej MA, Jensen L, Rowe B et al (2007) Systematic review of noninvasive positive pressure ventilation in severe stable COPD. Eur Respir J 30:293–306
Lavie P, Herer P, Lavie L (2007) Mortality risk factors in sleep apnoea: a matched case-control study. J Sleep Res 16:128–134
Little SA, Elkholy MM, Chalmers GW et al (1999) Predictors of nocturnal oxygen desaturation in patients with COPD. Respir Med 93:202–207
Lo Coco D, Mattaliano A, Lo Coco A et al (2009) Increased frequency of restless legs syndrome in chronic obstructive pulmonary disease patients. Sleep Med 10:572–576
Marin JM, Soriano JB, Carrizo SJ et al (2010) Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med 182:324–331
Martin RJ, Banks-Schlegel S (1998) Chronobiology of asthma. Am J Respir Crit Care Med 158:1002–1007
Mayer G, Braumann B, Ficker JH et al (2017) S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen, Kapitel „Schlafbezogene Atmungsstörungen“ Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM). Somnologie 20:97–180
McEvoy RD, Pierce RJ, Hillman D et al (2009) Australian trial of non-invasive ventilation in chronic airflow limitation (AVCAL) study group. Thorax 64:561–566
McNicholas WT (2017) COPD-OSA overlap syndrome: evolving evidence regarding epidemiology, clinical consequences, and management. Chest 152:1318–1326
McNicholas WT, Hansson D, Schiza S et al (2019) Sleep in chronic respiratory disease: COPD and hypoventilation disorders. Eur Respir Rev 28:190064
Mermigkis C, Kopanakis A, Foldvary-Schaefer N et al (2007) Health-related quality of life in patients with obstructive sleep apnoea and chronic obstructive pulmonary disease (overlap syndrome). Int J Clin Pract 61:207–211
Mieczkowski B, Ezzie ME (2014) Update on obstructive sleep apnea and its relation to COPD. Int J Chron Obstruct Pulmon Dis 9:349–362
Murphy PB, Rehal S, Arbane G et al (2017) Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation: a randomized clinical trial. JAMA 317:2177–2186
Omachi TA, Blanc PD, Clamann DM et al (2012) Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. Sleep Med 13:476–483
Ottenheijm CA, Heunks LM, Dekhuijzen RP (2008) Diaphragm adaptations in patients with COPD. Respir Res 24:9–12
Redolfi S, Yumino D, Ruttanaumpawan P et al (2009) Relationship between overnight rostral fluid shift and obstructive sleep apnea in nonobese men. Am J Respir Crit Care Med 179:241–246
Riemann D, Baum E, Cohrs S et al (2017) S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen. Somnologie 21:2–44
Storre JH, Steurer B, Kabitz H et al (2007) Transkutaneous pCO2 monitoring during inititiation of noninvasive ventilation. Chest 132:1810–1816
Struik FM, Lacasse Y, Goldstein RS et al (2013) Nocturnal noninvasive positive pressure ventilation in stable COPD: a systematic review and individual patient data meta-analysis. Respir Med 108(2):329–337
Struik FM, Sprooten RT, Kerstjens HA et al (2014) Nocturnal non-invasive ventilation in COPD patients with prolonged hypercapnia after ventilatory support for acute respiratory failure: a randomised, controlled, parallel-group study. Thorax 69:826–834
Tsolaki V, Pastaka C, Karetsi E et al (2008) One-year non-invasive ventilation in chronic hypercapnic COPD: effect on quality of life. Respir Med 102:904–911
Veale D, Cooper BG, Griffiths CJ et al (1994) The effect of controlled-release salbutamol on sleep and nocturnal oxygenation in patients with asthma and chronic obstructive pulmonary disease. Respir Med 88:121–124
Vogelmeier C, Buhl R, Burghuber O et al (2018) Leitlinie zur Diagnostik und Therapie von Patienten mit chronisch-obstruktiver Bronchitis und Lungenemphysem (COPD). Pneumologie 72:253–308
Wiegand L, Zwillich CW (1988) Pathogenesis of obstructive sleep apnea: role of the pharynx. Semin Respir Med 9:540–546
Wijkstra PJ, Lacasse Y, Guyatt GH et al (2003) A meta-analysis of nocturnal noninvasive pressure ventilation in patients with stable COPD. Chest 124:337–343
Windisch W, Dreher M, Geiseler J (2017) S2k-Leitlinie: Nichtinvasive und invasive Beatmung als Therapie der chronischen respiratorischen Insuffizienz – Revision. Pneumologie 71:722–795
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
W. Galetke gibt an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Rights and permissions
About this article
Cite this article
Galetke, W. Chronisch-obstruktive Lungenerkrankung (COPD) und Schlaf. Somnologie 24, 5–10 (2020). https://doi.org/10.1007/s11818-020-00237-w
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11818-020-00237-w