ABSTRACT
Patients with severe chronic obstructive pulmonary disease (COPD) and restrictive lung diseases have an altered control of breathing that leads to disturbances of gas exchange and sleep quality. It is very difficult to precisely evaluate the neural control of breathing in humans, awake or during sleep. Therefore, studies try to approach this indirectly with assessments of gas exchange, pulmonary mechanics, and respiratory muscle responses. Most investigations have examined normal awake subjects, and small numbers of patients usually limit what has been shown for those with disease while asleep. In addition, conclusions about sleep and breathing with or without nocturnal mechanical ventilation must be made cautiously, especially when comparing different respiratory diseases.
