ABSTRACT
RESPIRATORY DISEASE AND SLEEP During sleep, minute ventilation is reduced and hypercapnic and hypoxic respiratory drive is decreased, especially during rapid eye movement (REM) sleep (chap. 8). Patients with respiratory disease who are well compensated during waking hours may develop marked hypoxemia or hypercapnia during sleep that may contribute to morbidity and mortality. Thus, sleep can be a challenging time for patients with respiratory disease. Conversely, respiratory diseases adversely affect sleep, causing disruptive symptoms (cough, dyspnea, chest pain, and anxiety), disturbed gas exchange (hypoxemia and hypercapnia), the side effects of therapy, and more global changes in bedroom or social environment brought on by severe disease (semi-recumbent positioning, breathing or oxygen delivery apparatus, and separation from habitual bed partner). Being aware of how individual respiratory diseases and sleep affect one another can help the physician anticipate the needs of the patient and appropriate therapeutic alternatives.
