Le sommeil dans les affections respiratoires chroniques

Sleep interacts with respiration and vice versa. In normal subjects, these interactions have only minor consequences. However in patients with chronic respiratory diseases, sleep can have significant adverse effects on gas exchange. The mechanisms by which sleep influences respiratory failure is mainly hypoventilation and to a lesser degree ventilation perfusion mismatching Worsening of hypoxemia and hypercapnia during sleep is a common finding in chronic obstructive pulmonary disease (COPD). On the opposite, chronic respiratory diseases may deteriorate sleep quality, mainly by a decrease of total sleep time, due to prolonged episodes of awakenings. A number of these episodes are related to persistent symptoms, such as chronic cough, as demonstrated in cystic fibrosis or asthma. The association with a sleep apnea syndrome whether fortuitous or related to the underlying disease, is not unusual and may further deteriorate respiratory insufficiency during sleep. Patients with chronic respiratory disease, complain frequently of poor sleep quality, which has also an important impact on quality of life.