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特发性肺纤维化中的睡眠和呼吸。

Sleep and breathing in idiopathic pulmonary fibrosis.

机构信息

Lungcenter, St. Antonius Hospital, Wuppertal, Germany.

出版信息

J Physiol Pharmacol. 2009 Nov;60 Suppl 5:13-4.


DOI:
PMID:20134032
Abstract

The outcome of patients with idiopathic pulmonary fibrosis (IPF), which represents the most common type of idiopathic pulmonary pneumonias, is poor. Breathlessness and coughing are usually progressive and about 50% of he patients die within 3 years after diagnosis. The effect of medical treatment in terms of survival is disappointing. Most of the currently available studies only focus on daytime diagnostics and therapy. The role of sleep quality and sleep disordered breathing in IPF is only investigated in a small number of papers, which can be summarized as follows: sleep fragmentation in IPF is very common. The reasons might be coughing, nocturnal oxygen desaturations, and increased respiratory drive. Sleep disorders in IPF have a profound impact on the quality of life. Oxygen desaturations often appear during sleep and can be predicted by the PaO(2) during wakefulness. There are no evidence-based recommendations concerning the indication for oxygen therapy and non-invasive ventilation during sleep in IPF. Obstructive sleep apnea (OSA) has no increased incidence with the exception of the IPF patients with an increased body mass index. If, however, OSA is present in IPF oxygen desaturations are more profound. The therapy of sleep disorders and sleep disordered breathing in IPF is individual. But in the absence of an effective treatment of IPF, optimization of sleep and life quality by the treatment of sleep disorders seems to be a primary goal. Further studies are needed to determine special sleep-related treatment effects.

摘要

特发性肺纤维化(IPF)患者的预后较差,它是特发性间质性肺炎中最常见的类型。呼吸困难和咳嗽通常呈进行性发展,约 50%的患者在诊断后 3 年内死亡。目前的治疗方法在生存率方面效果不佳。大多数现有研究仅关注日间诊断和治疗。在少数研究中仅探讨了睡眠质量和睡眠呼吸障碍在 IPF 中的作用,可以总结如下:IPF 中睡眠碎片化非常常见。原因可能是咳嗽、夜间氧饱和度下降和呼吸驱动增加。IPF 中的睡眠障碍对生活质量有深远影响。睡眠期间经常出现氧饱和度下降,并且可以通过清醒时的 PaO2 预测。目前尚无关于 IPF 患者在睡眠期间进行氧疗和无创通气的指征的循证建议。除了体重指数增加的 IPF 患者外,阻塞性睡眠呼吸暂停(OSA)的发生率没有增加。但是,如果 IPF 中存在 OSA,则氧饱和度下降更为明显。IPF 中睡眠障碍和睡眠呼吸障碍的治疗是个体化的。但是,由于 IPF 缺乏有效治疗方法,因此通过治疗睡眠障碍来优化睡眠和生活质量似乎是首要目标。需要进一步的研究来确定特殊的与睡眠相关的治疗效果。

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