Böing Sebastian, Randerath Winfried J
Institut für Pneumologie an der Universität Witten Herdecke.
Klinik für Pneumologie und Allergologie, Schlaf- und Beatmungsmedizin, Bethanien Krankenhaus, Solingen.
Ther Umsch. 2014 May;71(5):301-8. doi: 10.1024/0040-5930/a000517.
Sleep disturbances (SD) are a frequent finding in patients with asthma and chronic obstructive pulmonary disease (COPD) and have a negative impact on quality of life and the clinical course of the disease. The causes of SD are multiple and include for example respiratory symptoms and comorbidities. On the other hand sleep goes along with multiple physiological changes in respiration, so that sleep itself interacts with asthma and COPD. This interaction favors respiratory symptoms and may lead to hypoxemia and hypercapnia. A further complication of the respiratory situation and the clinical course can be found in asthma and COPD patients with coexisting obstructive sleep apnea syndrome (OSAS). Due to the heterogeneity of SD in asthma and COPD, a detailed patient survey is the most important diagnostical tool. Based on the survey further technical examinations should be considered. Treatment strategies for the reduction of SD in asthma and COPD include an optimized medication and treatment of comorbidities. If indicated oxygen therapy, positive pressure breathing and pulmonary rehabilitation can contribute.
睡眠障碍(SD)在哮喘和慢性阻塞性肺疾病(COPD)患者中很常见,对生活质量和疾病的临床进程有负面影响。睡眠障碍的原因是多方面的,例如包括呼吸道症状和合并症。另一方面,睡眠伴随着呼吸方面的多种生理变化,因此睡眠本身与哮喘和慢性阻塞性肺疾病相互影响。这种相互作用会加重呼吸道症状,并可能导致低氧血症和高碳酸血症。在同时患有阻塞性睡眠呼吸暂停综合征(OSAS)的哮喘和慢性阻塞性肺疾病患者中,可发现呼吸状况和临床进程的进一步并发症。由于哮喘和慢性阻塞性肺疾病中睡眠障碍的异质性,详细的患者调查是最重要的诊断工具。基于该调查,应考虑进一步的技术检查。减少哮喘和慢性阻塞性肺疾病中睡眠障碍的治疗策略包括优化药物治疗和合并症的治疗。如果有指征,氧疗、正压通气和肺康复也会有帮助。