Expert Answers: When You Have Trouble Sleeping

When dealing with COPD, people often find that they may have trouble sleeping. Since there are sleeping conditions associated with COPD, we asked our expert respiratory therapists John, Leon, and Lyn this question on behalf of the community:

Since my COPD diagnosis, I have been having trouble with sleep – do you have any tips?

Response from John
This would be a great question to ask your physician. It is common for people with COPD to have trouble sleeping at night, so your physician should have some ideas that should help you sleep better. He may ask you questions to determine why you are having trouble sleeping: Is it trouble breathing? He may adjust your medicine or prescribe for you to take a breathing treatment just before bed to keep your airways open while you sleep. Is is sleep apnea? He may have you go for a sleep study and try something like CPAP or BiPAP. Is it anxiety? He may prescribe a sleeping pill or something for anxiety.

Response from Leon
Sleep problems and sleepiness are common problems for people who have COPD. Symptoms such as coughing, chest pain, and frequent nighttime urination may profoundly impact sleep. In addition, medications used to treat COPD may cause insomnia or even daytime sleepiness. Simply having to wake up and take prescriptions (on schedule) may also disturb sleep. Effects of this loss of quality sleep can range from mild to chronic fatigue. About 50% of COPD patients report significant trouble sleeping. Adverse effects from too little sleep may include poor concentration, mood swings and irritability.
Here are several ‘tips’ to help evaluate and address issues you may be having with sleep:

  • Medications: If a particular medication or medications are interfering with your sleep, ask your physician if there is an alternative medication you can take. This link is a handy resource to check out side effects of commonly used medications.
  • Sleep positions: Some patients with COPD find it difficult to sleep lying down and often use several pillows to prop themselves up to make breathing easier. However, it is difficult to get a full 6-8 hours of sleep in any kind of upright position. In these situations, you should check with your physician about nighttime oxygen therapy.
  • Nighttime oxygen therapy: Oxygen therapy has been known to help some people achieve a better night’s rest. Any prescribed therapy (e.g. oxygen) must be discussed with your physician. Nighttime oxygen therapy is typically recommended for patients diagnosed with stage IV COPD.
  • Designate a place to sleep: With few exceptions your bed should be the place you sleep. If you are predisposed to reading or watching television in bed, find another place for those activities. When you begin to feel drowsy, go to bed! Once you establish a routine of only sleeping in bed, your brain will automatically get sleepy when you get into bed after a long day. If you find yourself unable to sleep after lying in bed for 30 minutes, try reading while sitting up in another room until you feel drowsy and then get back into bed. The best results are achieved if you can establish a routine. Try to go to bed at the same time every night and get up at the same time every morning.
  • Exercise: Performing 10-30 minutes of exercise each day can help you get a better night’s rest. Exercising with COPD can be especially challenging, but by scheduling time and making an effort each day to get your heart rate up, can you achieve a better night’s sleep.
  • Don’t go to bed hungry: If you’re still hungry after dinner but before bed, have a small protein-packed snack. Try a handful of almonds or some cheese and crackers. Foods high in sugar and carbohydrates kick start your metabolism causing you to stay awake longer. Therefore, don’t eat sweet or starchy foods before bed. Avoid caffeinated drinks and carbonated beverages, too. Caffeine keeps you awake, and carbonated beverages can produce gas that pushes on the diaphragm, making breathing more difficult.
  • Sleep apnea: Sleep apnea is a sleep disorder that affects 10 to 15 percent of individuals with COPD. Because sleep apnea decreases oxygen levels and causes the airway to collapse, lung function is impacted even more significantly in patients with both disorders. It is important to discuss sleep apnea with your physician to determine if your difficulty sleeping may be caused by this disorder.

Response from Lyn
Since many with COPD find it difficult to sleep in a flat position, we often recommend using pillows to elevate your head. This may alleviate feelings of shortness of breath and the “I have an elephant on my chest” sensation. Additionally, if you aren’t already using oxygen at night, you may want to speak to your doctor about it. He or she may suggest you have a test done in which your oxygen levels are monitored overnight. If they drop, the doctor may suggest you wear some supplemental oxygen at night; in turn, this may help you get a better night’s sleep. Also, if you take nebulizers, you may find it beneficial to take the last one just before retiring at night. The temperature of your bedroom is also important; a room that’s cool is much easier to breathe and sleep in.

How about you? What’s your experience with COPD and sleep? Please share with us in the comments! 

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