Becker H F
Schwerpunkt Pneumologie, Klinik für Innere Medizin, Philipps-Universität Marburg.
Internist (Berl). 2004 Sep;45(9):1026-34. doi: 10.1007/s00108-004-1260-1.
Sleep is characterized by a profound change of load and capacity of the respiratory system. Load increases due to a rise in upper and lower airway resistance. Capacity decreases due to reduced chemosensitivity, a decrease in muscle activity and minute ventilation. Whereas these changes do not lead to relevant blood gas changes and do not disturb sleep in healthy subjects, patients with respiratory diseases frequently show the first symptoms of their disease during sleep. Pulmonary diseases in which sleep plays an important role are asthma, COPD, hypercapnic respiratory failure, sleep disordered breathing, the overlap-syndrome and cystic fibrosis. Medical history should include sleep and complaints during the night. In asthmatics peak-flow measurements during the night may provide valuable information. In all other disorders mentioned, nocturnal ambulatory recording of respiration and arterial oxygen saturation often allow the detection of relevant disorders of breathing during sleep. If ambulatory monitoring reveals relevant pathology, then further evaluation and treatment in the sleep laboratory are warranted.
睡眠的特征是呼吸系统的负荷和能力发生深刻变化。由于上、下气道阻力增加，负荷会上升。由于化学敏感性降低、肌肉活动减少和分钟通气量减少，能力会下降。虽然这些变化不会导致健康受试者出现相关的血气变化，也不会干扰睡眠，但患有呼吸系统疾病的患者在睡眠期间经常会出现其疾病的首发症状。睡眠起重要作用的肺部疾病包括哮喘、慢性阻塞性肺疾病（COPD）、高碳酸血症性呼吸衰竭、睡眠呼吸障碍、重叠综合征和囊性纤维化。病史应包括睡眠情况及夜间的不适。对于哮喘患者，夜间的峰值流量测量可能会提供有价值的信息。在上述所有其他疾病中，夜间动态记录呼吸和动脉血氧饱和度通常能够检测出睡眠期间相关的呼吸紊乱。如果动态监测发现相关病变，那么在睡眠实验室进行进一步评估和治疗是必要的。
