Parish James M
Sleep Disorders Center, Division of Pulmonary Medicine, Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ.
Chest. 2009 Feb;135(2):563-572. doi: 10.1378/chest.08-0934.
Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.
常见的医学问题往往与睡眠异常有关。与健康个体相比，患有慢性疾病的患者睡眠时间往往较少，且恢复性睡眠也较少，而这种睡眠不佳可能会加重疾病的主观症状。肺部疾病患者常常因氧饱和度下降、咳嗽或呼吸困难而睡眠紊乱。阻塞性肺病和限制性肺病都与睡眠质量差有关。未经治疗或治疗不足的哮喘患者睡眠中觉醒很常见，并会导致睡眠中断。胃食管反流是睡眠中断的主要原因，可因烧心、消化不良、反酸、咳嗽或窒息而觉醒。慢性肾病患者通常有睡眠问题，往往是由于失眠、睡眠不足、睡眠呼吸暂停或不宁腿综合征。在纤维肌痛和其他慢性疼痛病因的患者中，与睡眠相关的主诉非常常见。睡眠中断会增加疼痛感，降低生活质量。患有传染病的患者，包括急性病毒性疾病、HIV相关疾病和莱姆病，可能存在严重的失眠和嗜睡问题。更年期女性有失眠、睡眠呼吸紊乱、不宁腿综合征或纤维肌痛。患有癌症或接受癌症治疗的患者常常受到失眠或其他影响生活质量和日间精力的睡眠障碍的困扰。本文的目的是回顾常见的医学状况并探讨它们对睡眠的影响，以及回顾与这些常见医学状况相关的常见睡眠问题。
