Center for Sleep Disorders, Critical Care Committee, Chong Hua Hospital, Cebu City, Philippines; Cebu Doctors University College of Medicine, Cebu City, Philippines; Pulmonary and Pulmonary Critical Care, Chong Hua Hospital, Cebu City, Philippines.
Pulmonary and Pulmonary Critical Care, Chong Hua Hospital, Cebu City, Philippines.
Sleep Med Clin. 2022 Mar;17(1):99-109. doi: 10.1016/j.jsmc.2021.10.008.
This review presents the normal physiologic changes in ventilation during sleep and how they can be detrimental to chronic obstructive pulmonary disease (COPD). Sleep-related breathing disorders (SRBDs) in COPD lead to higher morbidity and mortality if left unrecognized and untreated. The diagnosis of SRBDs requires a high index of suspicion, as symptoms may overlap with other sleep disorders. Mortality risk is improved when patients with COPD with OSA (overlap syndrome) are treated with positive airway pressure and when long-term nocturnal noninvasive ventilation is started on chronic stable hypercapnic COPD. Treatment of isolated nocturnal oxygen desaturation has not been associated with improved survival.
这篇综述介绍了睡眠期间通气的正常生理变化，以及这些变化如何对慢性阻塞性肺疾病（COPD）产生不利影响。如果睡眠相关呼吸障碍（SRBDs）在 COPD 中得不到识别和治疗，会导致更高的发病率和死亡率。SRBDs 的诊断需要高度怀疑，因为症状可能与其他睡眠障碍重叠。当 COPD 合并阻塞性睡眠呼吸暂停（重叠综合征）患者接受气道正压治疗，以及当慢性稳定型高碳酸血症 COPD 患者开始长期夜间无创通气时，死亡率风险会降低。单独治疗夜间缺氧并没有改善生存率。
