Sleep and Breathing in Restrictive Thoracic Cage and Lung Disease

Restriction in pulmonary function is characterized by reduction in absolute lung volumes. The prototypical restrictive diseases include disorders of the chest wall and lung parenchyma and are characterized by significant respiratory abnormalities during sleep. Sleep may be disturbed by frequent respiratory-related arousals and hypoxemia may be profound, especially during rapid eye movement sleep. Patients with sleep-associated hypoventilation often suffer significant daytime functional sequelae and lowered survival rates. Although supplemental oxygen therapy may alleviate the nocturnal hypoxemia, nocturnal intermittent positive pressure ventilation with or without oxygen seems to improve daytime function and offers a survival advantage in severe disease.