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Rationale for Ventilation Therapy During Sleep

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Non Invasive Artificial Ventilation

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Abstract

Sleep is normally associated with significant changes in many physiological functions, including respiration. The most important differences between wakefulness and sleep are body position, control of breathing, changes in resistance to flow, the ventilatory response to changes in work load, and the coordinated activation of the respiratory muscles.

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Suggested Reading

  • Ambrogio C, Koebnick J, Quan SF, Ranieri VM, Parthasarathy S (2008) Assessment of sleep in ventilator-supported critically ill patients. Sleep 31(11):1559–1568

    PubMed  Google Scholar 

  • Appelberg J, Pavlenko T, Bergman H et al (2007) Lung aeration during sleep. Chest 131(1):122–129

    Article  PubMed  Google Scholar 

  • Ayappa I, Berger KI, Norman RG et al (2002) Hypercapnia and ventilatory periodicity in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 166(8):1112–1115

    Article  PubMed  Google Scholar 

  • Ballard RD, Clover CW, Suh BY (1995) Influence of sleep on respiratory function in emphysema. Am J Respir Crit Care Med 151(4):945–951

    CAS  PubMed  Google Scholar 

  • Becker HF, Piper AJ, Flynn WE et al (1999) Breathing during sleep in patients with nocturnal desaturation. Am J Respir Crit Care Med 159(1):112–118

    Article  CAS  PubMed  Google Scholar 

  • Bednarek M, Plywaczewski R, Jonczak L, Zielinski J (2005) There is no relationship between chronic obstructive pulmonary disease and obstructive sleep apnea syndrome: a population study. Respiration 72(2):142–149

    Article  PubMed  Google Scholar 

  • Berger KI, Ayappa I, Sorkin IB et al (2000) CO(2) homeostasis during periodic breathing in obstructive sleep apnea. J Appl Physiol 88(1):257–264

    CAS  PubMed  Google Scholar 

  • Berger KI, Ayappa I, Sorkin IB et al (2002) Postevent ventilation as a function of CO(2) load during respiratory events in obstructive sleep apnea. J Appl Physiol 93(3):917–924

    PubMed  Google Scholar 

  • Boyko Y, Ørding H, Jennum P (2012) Sleep disturbances in critically ill patients in ICU: how much do we know? Acta Anaesthesiol Scand 56:950–958

    Article  CAS  PubMed  Google Scholar 

  • Bradley TD, Rutherford R, Lue F et al (1986) Role of diffuse airway obstruction in the hypercapnia of obstructive sleep apnea. Am Rev Respir Dis 134(5):920–924

    CAS  PubMed  Google Scholar 

  • Bradley TD, Mateika J, Li D et al (1990) Daytime hypercapnia in the development of nocturnal hypoxemia in COPD. Chest 97(2):308–312

    Article  CAS  PubMed  Google Scholar 

  • Breslin E, van der Schans C, Breukink S et al (1998) Perception of fatigue and quality of life in patients with COPD. Chest 114(4):958–964

    Article  CAS  PubMed  Google Scholar 

  • Budweiser S, Riedl SG, Jörres RA et al (2007) Mortality and prognostic factors in patients with obesity-hypoventilation syndrome undergoing noninvasive ventilation. J Intern Med 261(4):375–383

    Article  CAS  PubMed  Google Scholar 

  • Catterall JR, Douglas NJ, Calverly PM et al (1983) Transient hypoxemia during sleep in chronic obstructive pulmonary disease is not a sleep apnea syndrome. Am Rev Respir Dis 128(1):24–29

    CAS  PubMed  Google Scholar 

  • Chan CS, Bye PT, Woolcock AJ, Sullivan CE (1990) Eucapnia and hypercapnia in patients with chronic airflow limitation. Am Rev Respir Dis 141(4 Pt 1):861–865 (The role of the upper airway)

    Article  CAS  PubMed  Google Scholar 

  • Chaouat A, Weitzenblum E, Krieger J et al (1995) Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am J Respir Crit Care Med 151(1):82–86

    Article  CAS  PubMed  Google Scholar 

  • Chaouat A, Weitzenblum E, Kessler R et al (1997) Sleep-related O2 desaturation and daytime pulmonary haemodynamics in COPD patients with mild hypoxaemia. Eur Respir J 10(8):1730–1735

    Article  CAS  PubMed  Google Scholar 

  • Chaouat A, Weitzenblum E, Kessler R et al (1999) A randomized trial of nocturnal oxygen therapy in chronic obstructive pulmonary disease patients. Eur Respir J 14(5):1002–1008

    Article  CAS  PubMed  Google Scholar 

  • Chaouat A, Weitzenblum E, Kessler R et al (2001) Outcome of COPD patients with mild daytime hypoxaemia with or without sleep-related oxygen desaturation. Eur Respir J 17(5):848–855

    Article  CAS  PubMed  Google Scholar 

  • Chapman KR, Mannino DM, Soriano JB et al (2006) Epidemiology and costs of chronic obstructive pulmonary disease. Eur Respir J 27(1):188–207

    Article  CAS  PubMed  Google Scholar 

  • Connaughton JJ, Catterall JR, Elton RA et al (1988) Do sleep studies contribute to the management of patients with severe chronic obstructive pulmonary disease? Am Rev Respir Dis 138(2):341–344

    Article  CAS  PubMed  Google Scholar 

  • Douglas NJ, Calverley PM, Leggett RJ et al (1979) Transient hypoxaemia during sleep in chronic bronchitis and emphysema. Lancet 1(8106):1–4

    Article  CAS  PubMed  Google Scholar 

  • Drouot X, Roche-Campo F, Thille AW, Cabello B, Galia F, Margarit L, d’Ortho MP, Brochard L (2012) A new classification for sleep analysis in critically ill patients. Sleep Med 13(1):7–14

    Article  PubMed  Google Scholar 

  • Dunroy HM, Adams L, Corfield DR, Morrell MJ (2003) CO2 retention in lung disease; could there be a pre-existing difference in respiratory physiology. Respir Physiol Neurobiol 136(2–3):179–186

    Article  PubMed  Google Scholar 

  • Fanfulla F, Grassi M, Taurino AE et al (2008) The relationship of daytime hypoxemia and nocturnal hypoxia in obstructive sleep apnea syndrome. Sleep 31(2):249–255

    PubMed  Google Scholar 

  • Fanfulla F, Ceriana P, D’Artavilla Lupo N, Trentin R, Frigerio F, Nava S (2011) Sleep disturbances in patients admitted to a step-down unit after ICU discharge: the role of mechanical ventilation. Sleep 34:355–362

    PubMed  Google Scholar 

  • Fleetham J, West P, Mezon B et al (1982) Sleep, arousals, and oxygen desaturation in chronic obstructive pulmonary disease. Am Rev Respir Dis 126(3):429–433

    CAS  PubMed  Google Scholar 

  • Flenley DC (1985) Sleep in chronic obstructive lung disease. Clin Chest Med 6(4):651–661

    CAS  PubMed  Google Scholar 

  • Fletcher EC, Miller J, Divine GW et al (1987) Nocturnal oxyhemoglobin desaturation in COPD patients with arterial oxygen tensions above 60 mmHg. Chest 92(4):604–608

    Article  CAS  PubMed  Google Scholar 

  • Fletcher EC, Scott D, Qian W et al (1991) Evolution of nocturnal oxyhemoglobin desaturation in patients with chronic obstructive pulmonary disease and a daytime PaO2 above 60 mmHg. Am Rev Respir Dis 144(2):401–405

    Article  CAS  PubMed  Google Scholar 

  • Fletcher EC, Donner CF, Midgren B et al (1992) Survival in COPD patients with a daytime PaO2 greater than 60 mmHg with and without nocturnal oxyhemoglobin desaturation. Chest 101(3):649–655

    Article  CAS  PubMed  Google Scholar 

  • Flick MR, Bloch AJ (1977) Continuous in vivo monitoring of arterial oxygenation in chronic obstructive lung disease. Ann Intern Med 86(6):725–730

    Article  CAS  PubMed  Google Scholar 

  • Freedman DS, Khan LK, Serdula MK et al (2002) Trends and correlates of class 3 obesity in the United States from 1990 through 2000. JAMA 288(14):1758–1761

    Article  PubMed  Google Scholar 

  • Gòrecka D, Gorzelak K, Sliwinski P et al (1997) Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia. Thorax 52(8):674–679

    Article  PubMed  Google Scholar 

  • Guilleminault C, Cummiskey J, Motta J (1980) Chronic obstructive airflow disease and sleep studies. Am Rev Respir Dis 122(3):397–406

    CAS  PubMed  Google Scholar 

  • Hudgel DW, Martin RJ, Johnson B, Hill P (1984) Mechanics of the respiratory system and breathing pattern during sleep in normal humans. J Appl Physiol 56(1):133–137

    CAS  PubMed  Google Scholar 

  • Iber C, Ancoli-Israel S, Chesson AL, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications, 1st edn. American Academy of Sleep Medicine, Westchester

    Google Scholar 

  • Jennum P, Riha RL (2009) Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. Eur Respir J 33(4):907–914

    Article  CAS  PubMed  Google Scholar 

  • Johnson MW, Remmers JE (1984) Accessory muscle activity during sleep in chronic obstructive pulmonary disease. J Appl Physiol 57(4):1011–1017

    CAS  PubMed  Google Scholar 

  • Jones RL, Nzekwu MM (2006) The effects of body mass index on lung volumes. Chest 130(3):827–833

    Article  PubMed  Google Scholar 

  • Koo KW, Sax DS, Snider GL (1975) Arterial blood gases and pH during sleep in chronic obstructive pulmonary disease. Am J Med 58(5):663–670

    Article  CAS  PubMed  Google Scholar 

  • Laaban JP, Chailleux E (2005) Daytime hypercapnia in adult patients with obstructive sleep apnea syndrome in France, before initiating nocturnal nasal continuous positive airway pressure therapy. Chest 127(3):710–715

    Article  PubMed  Google Scholar 

  • Larsson LG, Lindberg A, Franklin KA et al (2001) Obstructive sleep apnoea syndrome is common in subjects with chronic bronchitis. Respiration 68(3):250–255 (Reports from the Obstructive Lung Disease in Northern Sweden studies)

    Article  CAS  PubMed  Google Scholar 

  • Leitch AG, Clancy LJ, Leggett RJ et al (1976) Arterial blood gas tensions, hydrogen ion, and electroencephalogram during sleep in patients with chronic ventilatory failure. Thorax 31(6):730–735

    Article  CAS  PubMed  Google Scholar 

  • Levine S, Kaiser L, Leferovich J, Tikunov B (1997) Cellular adaptations in the diaphragm in chronic obstructive pulmonary disease. N Engl J Med 337(25):1799–1806

    Article  CAS  PubMed  Google Scholar 

  • Levi-Valensi P, Weitzenblum E, Rida Z et al (1992) Sleep-related oxygen desaturation and daytime pulmonary haemodynamics in COPD patients. Eur Respir J 5(3):301–307

    CAS  PubMed  Google Scholar 

  • Lewis CA, Eaton TE, Fergusson W et al (2003) Home overnight pulse oximetry in patients with COPD: more than one recording may be needed. Chest 123(4):1127–1133

    Article  PubMed  Google Scholar 

  • Little SA, Elkholy MM, Chalmers GW et al (1999) Predictors of nocturnal oxygen desaturation in patients with COPD. Respir Med 93(3):202–207

    Article  CAS  PubMed  Google Scholar 

  • Macgowan NA, Evans KG, Road JD, Reid WD (2001) Diaphragm injury in individuals with airflow obstruction. Am J Respir Crit Care Med 163(7):1654–1659

    Article  CAS  PubMed  Google Scholar 

  • Machado MCL, Vollmer VM, Togeiro SM, Bilderback AL, Oliveira MVC, Leitao FS, Queiroga F Jr, Lorenzi-Filho G, Krishnane JA (2010) CPAP and survival in moderate-to-severe obstructive sleep apnoea syndrome and hypoxaemic COPD. Eur Respir J 35:132–137

    Article  PubMed  Google Scholar 

  • Marik PE, Desai H (2013) Characteristics of patients with the “Malignant Obesity Hypventilation Syndrome” admitted to an ICU. J Intensive Care 28(2):124–130

    Google Scholar 

  • Marin JM, Soriano JB, Carrizo SJ, Boldoval A, Celli BR (2010) Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med 182:325–331

    Article  PubMed  Google Scholar 

  • Marshall NS, Barnes M, Travier N et al (2006) Continuous positive airway pressure reduces daytime sleepiness in mild to moderate obstructive sleep apnoea: a meta-analysis. Thorax 61(5):430–434

    Article  CAS  PubMed  Google Scholar 

  • McNicholas WT (2000) Impact of sleep in COPD. Chest 117(Suppl 2):48S–53S

    Article  CAS  PubMed  Google Scholar 

  • Mokhlesi B, Kryger MH, Grunstein RR (2008) Assessment and management of patients with obesity hypoventilation syndrome. Proc Am Thorac Soc 5(2):218–225

    Article  PubMed Central  PubMed  Google Scholar 

  • Mulloy E, McNicholas WT (1993) Theophylline improves gas exchange during rest, exercise, and sleep in severe chronic obstructive pulmonary disease. Am Rev Respir Dis 148(4 Pt 1):1030–1036

    Article  CAS  PubMed  Google Scholar 

  • Mulloy E, McNicholas WT (1996) Ventilation and gas exchange during sleep and exercise in severe COPD. Chest 109(2):387–394

    Article  CAS  PubMed  Google Scholar 

  • Mutlu GM, Rubinstein I (2005) The saga of obstructive sleep apnea syndrome and daytime hypercapnia: work in progress. Chest 127(3):698–699

    Article  PubMed  Google Scholar 

  • Norman RG, Goldring RM, Clain JM et al (2006) Transition from acute to chronic hypercapnia in patients with periodic breathing: predictions from a computer model. J Appl Physiol 100(5):1733–1741

    Article  CAS  PubMed  Google Scholar 

  • O’Donoghue FJ, Catchside PG, Ellis EE et al (2003) Sleep hypoventilation in hypercapnic chronic obstructive pulmonary disease: prevalence and associated factors. Eur Respir J 21(6):977–984

    Article  PubMed  Google Scholar 

  • O’Donoghue FJ, Catchside PG, Ecker DJ, McEvoy RD (2004) Changes in respiration in NREM sleep in hypercapnic chronic obstructive pulmonary disease. J Physiol 559(Pt 2):663–673

    Article  PubMed  Google Scholar 

  • Plywaczewski R, Sliwinski P, Nowinski A et al (2000) Incidence of nocturnal desaturation while breathing oxygen in COPD patients undergoing long-term oxygen therapy. Chest 117(3):679–683

    Article  CAS  PubMed  Google Scholar 

  • Poole DC, Sexton WL, Farkas GA et al (1997) Diaphragm structure and function in health and disease. Med Sci Sports Exerc 29(6):738–754

    Article  CAS  PubMed  Google Scholar 

  • Prioux P, Hamel JF, Person C, Meslier N, Racineux JL, Urban T, Gagnadoux F (2010) Long-term outcome of noninvasive positive pressure ventilation for obesity hypoventilation syndrome. Chest 138(1):84–90

    Google Scholar 

  • Raurich JM, Rialp G, Ibanez J, Llompart-Pou JA, Ayestaran J (2010) Hypercapnic respiratory failure in obesity-hypoventilation syndrome: CO2 response and acetazolamide treatment effects. Respir Care 55(11):1442–1448

    PubMed  Google Scholar 

  • Reid WD, Samrai B (1995) Respiratory muscle training for patients with chronic obstructive pulmonary disease. Phys Ther 75(11):996–1005

    CAS  PubMed  Google Scholar 

  • Resta O, Foschino-Barbaro MP, Bonfitto P et al (2000) Prevalence and mechanisms of diurnal hypercapnia in a sample of morbidly obese subjects with obstructive sleep apnoea. Respir Med 94(3):240–246

    Article  CAS  PubMed  Google Scholar 

  • Sajkov D, McEvoy RD (2009) Obstructive sleep apnea and pulmonary hypertension. Prog Cardiovasc Dis 51(5):363–370

    Article  PubMed  Google Scholar 

  • Sandek K, Andersson T, Bratel T et al (1999) Sleep quality, carbon dioxide responsiveness and hypoxaemic patterns in nocturnal hypoxaemia due to chronic obstructive pulmonary disease (COPD) without daytime hypoxemia. Respir Med 93(2):79–87

    Article  CAS  PubMed  Google Scholar 

  • Sanders MH, Newman AB, Haggerty CL et al (2003) Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med 167(1):7–14

    Article  PubMed  Google Scholar 

  • Sergi M, Rizzi M, Andreoli A et al (2002) Are COPD patients with nocturnal REM sleep-related desaturations more prone to developing chronic respiratory failure requiring long-term oxygen therapy? Respiration 69(2):117–122

    Article  PubMed  Google Scholar 

  • Sliwinski P, Macklem PT (1997) Inspiratory muscle dysfunction as a cause of death in COPD patients. Monaldi Arch Chest Dis 52(4):380–383

    CAS  PubMed  Google Scholar 

  • Stradling JR, Lane DJ (1983) Nocturnal hypoxaemia in chronic obstructive pulmonary disease. Clin Sci (Lond) 64:213–222

    CAS  Google Scholar 

  • Tabachnick E, Muller NL, Bryan AC, Levison H (1981) Changes in ventilation and chest wall mechanics during sleep in normal adolescents. J Appl Physiol 51(3):557–564

    Google Scholar 

  • Toraldo DM, Nicolardi G, De Nuccio F et al (2005) Pattern of variables describing desaturator COPD patients, as revealed by cluster analysis. Chest 128(6):3828–3837

    Article  PubMed  Google Scholar 

  • Trask CH, Cree EM (1962) Oximeter studies on patients with chronic obstructive emphysema, awake and during sleep. N Engl J Med 266:639–642

    Article  CAS  PubMed  Google Scholar 

  • Veale D, Chailleux E, Taytard A, Cardinaud JP (1998) Characteristics and survival of patients prescribed long-term oxygen therapy outside prescription guidelines. Eur Respir J 12(4):780–784

    Article  CAS  PubMed  Google Scholar 

  • Vos PJ, Folgering HT, van Herwaarden CL (1995) Predictors for nocturnal hypoxaemia (mean SaO2 < 90%) in normoxic and mildly hypoxic patients with COPD. Eur Respir J 8(1):74–77

    Article  CAS  PubMed  Google Scholar 

  • Wang D, Piper AJ, Wong KK et al (2011) Slow wave sleep in patients with respiratory failure. Sleep Med 12:378–383

    Article  PubMed  Google Scholar 

  • White JE, Drinnan MJ, Smithson AJ et al (1995) Respiratory muscle activity and oxygenation during sleep in patients with muscle weakness. Eur Respir J 8(5):807–814

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Respiratory and Critical Care Unit, AO Sant’ Orsola Malpighi Hospital, Bologna, Italy

    Stefano Nava

  2. Sleep Medicine Unit, Fondazione Salvatore Maugeri Division Pneumologica, Pavia, Italy

    Francesco Fanfulla

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  1. Stefano Nava
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  2. Francesco Fanfulla
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Correspondence to Stefano Nava .

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Nava, S., Fanfulla, F. (2014). Rationale for Ventilation Therapy During Sleep. In: Non Invasive Artificial Ventilation. Springer, Milano. https://doi.org/10.1007/978-88-470-5526-1_23

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