Improving Sleep Quality for Individuals with Chronic Lung Conditions

Sleep helps our brain function properly. Not getting enough sleep, or a poor quality of sleep, has many potential consequences to our health and wellbeing. The most obvious concerns are fatigue, irritability, problems focusing, and challenges with decision making. Individuals who suffer with chronic sleep problems may often face symptoms of anxiety, depression, and mood disorders as a result. This can be a challenging cycle to break as inadequate sleep can exacerbate mental health conditions and these same conditions often will cause difficulty with sleep. Individuals with a chronic lung condition, such as chronic obstructive pulmonary disease (COPD), often experience poor sleep quality; this likely contributes to the chronic fatigue, sleepiness, and overall impairment in quality of life reported by individuals with COPD.

Impact of Respiratory Disease on Sleep Quality

Mild obstructive airway disease has little impact on sleep quality. However, as obstruction becomes more severe, there are an increasing number of sleep complaints with possibly more deleterious physiological effects. There is also an increased prevalence of insomnia, which is a common sleep disorder that can make it hard to fall asleep or hard to stay asleep. Furthermore, a higher use of sleeping medications and an increase in daytime sleepiness is reported by individuals with severe respiratory disease compared to the general population.

Common Sleeping Problems Seen With Respiratory Disease

Trouble going to sleep
Trouble staying asleep
Sleepiness during the daytime
Waking up due to headaches
Waking up due to shortness of breath
Brief periods of not breathing during sleep
Nightmares

What Causes These Sleep Issues?

Sleep Apnea

Sleep apnea is when breathing repeatedly stops and starts while asleep. Many people with sleep apnea snore very loudly and often feel tired during the day, even after a full night’s sleep.

Sleep apnea is not caused by respiratory disease but having a respiratory disease can make the symptoms of sleep apnea worse. People with sleep apnea often sleep better using a special mask that prevents breathing from stopping and starting during the night.

Respiratory Disease Symptoms

Symptoms such as coughing, wheezing and/or shortness of breath can wake a person up several times during the night. Some people find it helpful to sleep with their heads raised on 2 to 3 pillows to allow the lungs to expand more fully. There are also medications that can be used to treat these symptoms.

Low Levels of Oxygen during Sleep

Breathing patterns change when we are asleep. For people with respiratory disease, this change can cause a low level of oxygen in the blood at different times during the night. This can make individuals with respiratory disease have poor quality of sleep and feel tired during the day. The lack of oxygen in the blood can lead to many other problems. If you are experiencing sleeping problems, consult with your healthcare provider to see if low levels of oxygen in the blood are the cause. If so, you might be recommended to have oxygen therapy during the night. Oxygen therapy is a treatment that delivers oxygen gas for you to breathe via tubes resting in your nose, a face mask, or a tube placed in your trachea or windpipe. This treatment increases the amount of oxygen your lungs receive and is delivered to your blood.

Anxiety and Depression

Anxiety and depression can both cause insomnia. Treatment for anxiety or depression can help reduce these sleep problems.

If you are experiencing sleeping problems, you should let your healthcare provider know.

Healthy Sleep Habits

Your routine during the day, and especially before bedtime, can have a major impact on your sleep. They can promote healthy sleep or contribute to sleeplessness. Practicing healthy sleep habits, or sleep hygiene, can significantly impact your quality of sleep.

Sleep Hygiene Tips

Keep a consistent sleep schedule. Go to bed and get up at the same time every day, even on weekends or during vacations.
Set a bedtime that is early enough for you to get at least 7 hours of sleep.
Don’t go to bed unless you are sleepy.
If you don’t fall asleep after 20 minutes, get out of bed.
Establish a relaxing bedtime routine.
Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
Limit exposure to bright light in the evenings.
Turn off electronic devices at least 30 minutes before bedtime. Electronic devices include TVs, computers, and smartphones. Another step would be to remove these devices from the bedroom completely.
Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
Exercise regularly and maintain a healthy diet.
Avoid consuming caffeine in the late afternoon or evening.
Avoid consuming alcohol before bedtime.
Reduce your fluid intake before bedtime.

Foods to Aid Sleep

Foods that are rich in magnesium help relax muscles and aid in inducing a sleepy state. High sources of magnesium include greens, leafy vegetables, pumpkin seeds, chickpeas, edamame, bananas, avocados, beans, nuts, and seeds.

Certain foods contain an amino acid called tryptophan. Tryptophan is a sleep-enhancing amino acid that helps produce serotonin and melatonin, the hormones that set our sleep-wake cycles. Foods containing tryptophan include:

Lean proteins such as chicken, turkey, fish, and eggs. Try to avoid high-fat cheese and deep-fried chicken or fish.
Whole grains such as barley, buckwheat, and other complex carbohydrates help convert tryptophan into melatonin and serotonin. Avoid simple carbohydrates such as pasta, breads made with flour, and sweets (cookies, cake, etc.).

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Pulmonary rehabilitation helps ease respiratory symptoms, improve physical and psychological well-being, and increase disease management. Please discuss your decision to begin online pulmonary rehabilitation with a doctor or health care provider.