Thorax Institute, Hospital Clinic, IDIBAPS, Villaroel 1170, Barcelona, Spain.
Eur Respir Rev. 2011 Sep 1;20(121):183-94. doi: 10.1183/09059180.00004311.
Sleep quality is often poor in patients with chronic obstructive pulmonary disease (COPD), but these night-time symptoms are frequently unnoticed by physicians and/or not reported by patients themselves. Therefore, the prevalence and clinical impact of sleep disturbances and night-time symptoms in COPD is not well understood and has not been a clinical focus to date. To address this gap, an expert panel meeting was convened in Barcelona, Spain, in March 2011 to discuss the aetiology, evolution, burden, long-term clinical consequences and optimal management of night-time symptoms in COPD. The term "night-time symptoms" in COPD has not been distinctly defined in an objective sense but epidemiological data suggests that the prevalence of nocturnal symptoms and symptomatic sleep disturbance may exceed 75% in patients with COPD. The panel concluded that night-time symptoms in COPD are prevalent and bothersome; that their cause(s) are multiple and include demographic factors, such as age and obesity, pharmacotherapy, disease-specific symptoms and the presence of comorbid sleep disorders, and other medical conditions; and that potential long-term consequences can include lung function changes, increased exacerbation frequency, emergence or worsening of cardiovascular disease, cognitive effects, depression, impaired quality of life and increased mortality. To date, few interventional studies have investigated them, but emerging data suggest that bronchodilator therapy can improve them if deployed appropriately. In summary, night-time symptoms in COPD warrant further clinical investigation with validated tools.
慢性阻塞性肺疾病（COPD）患者的睡眠质量通常较差，但这些夜间症状常常被医生忽视和/或患者自己没有报告。因此，COPD 患者睡眠障碍和夜间症状的流行程度和临床影响尚不清楚，也不是目前的临床重点。为了解决这一差距，2011 年 3 月在西班牙巴塞罗那召开了一个专家小组会议，讨论 COPD 夜间症状的病因、演变、负担、长期临床后果和最佳管理。COPD 中的“夜间症状”一词尚未从客观意义上明确界定，但流行病学数据表明，夜间症状和有症状的睡眠障碍在 COPD 患者中的患病率可能超过 75%。专家组得出结论，COPD 中的夜间症状普遍存在且令人困扰；其病因多种多样，包括人口统计学因素，如年龄和肥胖，药物治疗，疾病特异性症状以及并存的睡眠障碍和其他医疗条件；潜在的长期后果可能包括肺功能变化、加重频率增加、心血管疾病的出现或恶化、认知影响、抑郁、生活质量受损和死亡率增加。迄今为止，很少有干预性研究对其进行研究，但新出现的数据表明，如果适当使用支气管扩张剂治疗，这些症状可能会得到改善。总之，COPD 中的夜间症状需要进一步用经过验证的工具进行临床研究。
