Multiple factors can cause people with chronic obstructive pulmonary disease (COPD) to lose out on a good night’s sleep.
Medications and nighttime COPD symptoms are 2 factors that lead many COPD patients to experience insomnia and sleep disturbances.
Lack of sleep can lead to daytime sleepiness, chronic fatigue and diminished quality of life for people who have COPD. And it can also lead to an increased number of exacerbations and more medical care for COPD patients.
Here, I’ll review some of the factors that lead to poor sleep for COPD patients, and what research has discovered about the links between sleep disturbances and exacerbations.
What Causes Poor Sleep in COPD Patients?
Many factors can contribute to insomnia and sleep disturbances for COPD patients, including:
- Ongoing symptoms like difficulty breathing, coughing, wheezing and mucus production. Some people have dyspnea (shortness of breath) while lying flat, and others have paroxysmal nocturnal dyspnea, which causes patients to wake up in the night feeling short of breath.
- A secondary sleep disorder like obstructive sleep apnea (OSA), nocturnal hypoxemia or sleep-related hypoventilation (breathing at an abnormally slow rate). Frequent episodes of sleep apnea, low blood oxygen levels in the blood (nocturnal hypoxemia) and build-up of carbon dioxide in the blood can all cause frequent arousals during the night, difficulty breathing, daytime sleepiness and morning headaches.
- Medication side effects. Bronchodilators are commonly prescribed to COPD patients, but 1 side effect of bronchodilator use is difficulty falling asleep for some people.
- Overnight nicotine withdrawal. This applies if you currently smoke or are trying to quit. As nicotine wears off during the night, withdrawal symptoms can include difficulty falling asleep, waking up in the middle of the night and experiencing restless sleep.
- Anxiety or depression. Anxiety, depression and feelings of distress can prevent you from calming your mind and body enough to fall asleep and sleep deeply. Medications to treat anxiety and depression can also cause insomnia.
Lack of Sleep Leads to More COPD Exacerbations
A study published in European Respiratory Review evaluated patients with COPD and reported that over 75% experienced nighttime symptoms and sleep disturbances related to their disease.
The study found that patients who had nocturnal symptoms and difficulty falling or staying asleep had more daytime breathlessness, increased number of exacerbations and were taking more maintenance medications than patients who reported no nighttime symptoms.
The study concluded that COPD patients with nocturnal symptoms and disturbed sleep might be at higher risk for uncontrolled disease with more exacerbations.
Another study followed 98 patients with COPD for over 2 years to evaluate if disturbed sleep was associated with an increase in exacerbations. The study found that disturbed sleep was able to predict more COPD exacerbations and more hospitalizations or ER visits.
If you have poor sleep quality due to your condition, talk to your doctor about adjusting the medications you take at night, testing you for sleep apnea and finding sleeping positions that reduce nighttime symptoms.
Christine Kingsley, APRN is the Health and Wellness Director at the Lung Institute where she focuses on providing helpful online resources for people looking for information on various lung diseases, breathing exercises, and healthy lifestyle choices. She advocates for holistic care that involves working with your doctor to explore all options including traditional and alternative care while focusing on diet and exercise as proactive measures.