Friday, December 24, 2010

Lack of Sleep and COPD

Trying to get enough sleep is difficult especially on Christmas Eve, but lack of sleep and COPD can make falling asleep easy worse. COPD or chronic obstructive pulmonary disease causes people to wake up frequently during the night and takes longer for them to fall asleep due to chest pain, tightness, coughing and wheezing. Other symptoms of COPD are acid reflux, hormonal fluctuations and sleep apnea. Over time COPD can lead to bronchitis and emphysema and sleep deprived health problems such as memory loss, weight gain, diabetes, pulmonary hypertension and heart disease.

The main causes are smoking, pollution and other lung irritants. Eliminating these irritants is a good healthy start to alleviate COPD symptoms. Lifestyle changes including a diet full of fruit, vegetables and whole grains may help people with COPD get a better night’s sleep as well as taking antioxidants and minerals that can contribute to better lung function. These minerals include vitamin A, C and E, potassium, magnesium, selenium and zinc.

[caption id="attachment_757" align="alignright" width="300" caption="Lack of Sleep and COPD - Emphysema or Bronchitis "][/caption]

If your COPD is due to emphysema or chronic bronchitis your doctor may recommend an anticholinergic inhaler which inhibits nerve impulses and reduces nighttime coughing and wheezing. Other alternative treatments may include steroid inhalers to reduce airway inflammation and pulmonary rehabilitation which focuses on exercise, nutrition and deep breathing training. In some serious cases, you may need extra oxygen.

COPD caused by heartburn that is a result of acid reflux or GERD (gastro esophageal reflux disease) can cause a chronic cough that often worsens bronchitis. Acid reflux prescription drugs and over-the-counter medications are available to control symptoms. Other acid reflux triggers are alcohol, caffeine, chocolate, tobacco and items that contain peppermint or spearmint. I find that raw onions and spicy food contribute to my heartburn and indigestion especially when eaten late at night. That is why it is important to eat smaller meals at night and if you like to have a snack before bedtime to avoid hot spicy foods and stick to foods that are easy on the digestion track and full of tryptophan, as foods rich in tryptophan will help you to fall asleep.

Some COPD medications such as anticholinergics and beta agonists are bronchodilators that relax muscles around airways to make breathing easier. Beta agonists can interfere with sleep as they stimulate the nervous system that may increase your heart rate, raise your blood pressure and trigger the flight or flight reaction. So when you lie down in bed at night and continually toss and turn because you can’t relax, talk to your physician to change your medication or adjust your dosage.

Did you know that a sleeping position may make it more difficult to breathe when you have COPD? That is because pressure on your diaphragm makes it harder to inflate a damaged lung. Blood oxygen levels drop when you are lying on your back compared to sitting or standing, therefore, it is recommended to elevate the head of your bed using a memory foam pillow wedge or sleep in an adjustable bed.

Sleep apnea can be an overlap syndrome when you have this disorder with COPD. Sleep apnea is when you stop breathing periodically during the night. If you suffer from COPD and sleep apnea is it imperative that you get treated for these condition because low blood oxygen including occasional lack of breathe or diminished breathe can starve the heart muscle of oxygen that can result in heart arrhythmia, congestive heart failure, myocardial infarction and even death. Make sure you get tested for oxygen levels along with a polysomnogram which measures brain activity, eye movements, heart rate and blood pressure while you sleep. You may be required to wear a CPAP (continuous positive airway pressure) face mask as part of your treatment.

[caption id="attachment_758" align="alignright" width="270" caption="Lack of Sleep and COPD - Are YOU at Risk?"][/caption]

Pregnant women with COPD can have worsening symptoms due to the increase in estrogen that can have inflammatory effects which swell mucous membranes making breathing more difficult. Often in their third trimester, pregnant women’s upper airway passages become narrowed due to more pressure on the chest cavity that can contribute to snoring and sleep apnea. If you are taking progesterone it may improve your sleep apnea but it may trigger a temporary interruption of the drive to breathe when carbon dioxide is too low, also known as central apneas. Remember, it is more dangerous for your child if you don’t keep up with your medications, because lack of oxygen and difficulty breathing puts the fetus at risk. Find elongated positions so the baby doesn’t press up against your chest cavity and watch how much weight you gain. Extra weight and COPD increase a demand on the heart and lungs.

40% of patients with COPD experience depression or anxiety and many doctors recommend cognitive behavior therapy or psychotherapy instead of common antidepressants such as SSRIs or SNRIs because they promote weight gain which can worsen COPD and sleep problems. See: Medications that Affect Sleep.

Social support and exercise as well as a healthy lifestyle can help those with COPD get a good night’s sleep. The content in Lack of Sleep and COPD is for information purposes only, intended to raise the awareness of different solutions for your sleep problems and should not be considered medical advice. For medical diagnosis and treatment, please see your qualified health-care professional.
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