If you or someone you know has COPD or asthma, chances of having to cope with sleep difficulties are high. Over 75% of persons with COPD report problems with sleeping. Anyone with lung disorders can experience breathing difficulties while lying down. Simply falling asleep can be challenging, and many awaken to some extent several times each night.
Such problems should not be taken lightly. Anyone, but especially those with lung disease, can experience dangerously low levels of oxygen in the blood and high levels of carbon dioxide. These situations can increase risk of stroke, heart failure, and other problems such as extreme fatigue, reduced memory, and moodiness when awake.
Symptoms of Sleep Problems
If you have any of the following symptoms, you should consult your primary health care provider.
- Snoring, gasping for breath, cessation of breathing for 10 seconds or longer (usually these symptoms are noticed by a caregiver or partner who is physically present)
- Headache, especially on awakening in the morning
- Excessive sleepiness during the day
- Reduced oxygen saturation during the day
- Opioid prescription use
- History of type 2 diabetes, heart failure, or stroke
Depending on the seriousness of your condition, you might be asked to take a sleep test to pinpoint the nature of your problem and what might be causing it.
Since sleep is affected by several lifestyle factors, causes other than those directly associated with your airway should be considered.
For example, if you have COPD, you might encounter gastroesophageal reflux disease (GERD) while lying down. This can cause you to awaken, cough, and have your sleep interrupted for a while.
Other factors can include your sleeping environment (room is too warm, not dark enough, subject to noise), watching TV, or interacting with electronic devices.
Obstructive Sleep Apnea (OSA)
Obstructive Sleep Apnea (OSA) is one of the most common problems facing those with difficulty in breathing. Contrary to what some believe, COPD does not cause or increase the chances of developing sleep apnea. But many persons with COPD do in fact develop sleep apnea, and that can cause their overall condition to worsen.
If you stop breathing briefly (10 seconds or longer) during the night, you might have sleep apnea. Some persons have hundreds of these interruptions every night. Causes of these interruptions vary, but a common cause occurs when the muscles and tissue in the back of your throat relax while you’re sleeping and block your airway. These disruptions might or might not awaken you fully.
Pauses in your breathing are often accompanied by snoring and gasping for breath. Since you are unlikely to hear your own snoring, ask your partner or someone who is with you at night whether you snore or stop breathing.
Having both COPD and OSA is called “Overlap Syndrome”—a situation that can be very serious and lead to higher risk of heart attack or stroke.
Treatment of Sleep Problems
There are a variety of methods to consider in order to get more restful sleep.
Some persons are able to fall asleep and avoid waking during the night by sleeping on an incline with their head slightly elevated. (There are over-the-counter wedges that can be used on top of or underneath your mattress to raise the top portion of your body a few inches.) This can help to reduce GERD and keep mucus from blocking your nose and throat. (Sitting up completely can make falling asleep difficult.)
Not eating or drinking fluids after your last meal of the day can reduce having to get up during the night to relieve yourself.
Avoid drinking alcoholic beverages, especially during the evening. Quit smoking.
Try not to take naps, especially long ones, late in the day.
Maintain an exercise routine.
To treat OSA, many physicians prescribe using a CPAP (Continuous Positive Airway Pressure) machine. A CPAP machine has a small motor that supplies a mild, continuous airflow to a mask that covers your nose and mouth and keeps your airway open. There are also variants that make exhaling a little easier.
If you are on Medicare, CPAP machines are considered as “Durable Medical Equipment.” Provided that your physician prescribes such a machine, Medicare and Medicare Advantage plans typically cover 80% of purchase or rental costs and 80% of the cost of supplies. Be sure to check with your insurance carrier and your physician for more details.
Your physician might advise surgery to reduce sleep apnea symptoms. There are several types of surgery, each of which seeks to address different problem areas.
For example, nasal surgery can correct a deviated septum and widen nasal passages. Another common approach is to remove excess tissue from the top of your throat and back of your mouth (including tonsils, if present). Some surgical procedures require brief hospitalization while others can be completed on an outpatient basis. Please consult this Healthline summary of surgery for sleep apnea for more information.
Instead of or in addition to the above treatment procedures, you physician might adjust your medications. Some medications actually increase risk of sleep apnea, and your physician might prescribe different ones to avoid that side effect. Your physician might also adjust how and when your medications are administered.
Above all, please discuss treatment and payment options with your primary health care provider. The possible options for treatment are many and varied, and your physician can help you determine which approach best suits your particular circumstances.
Getting sufficient and high-quality sleep is important for good health for everyone. If you have COPD or asthma, doing so is especially important to reduce your symptoms and improve the quality of your daily life. If you are experiencing sleep problems, please follow up on these suggestions and talk to your doctor.
WebMD: Sleep Apnea Health Center (several topics covered)