Sleep-related hypoxemia is treated effectively with oxygen therapy. This results in improved symptoms and may lessen mortality. Current guidelines for oxygen therapy are based on waking blood gases as no oxygen data during sleep were collected. Until such data become available, it seems reasonable to correct gross hypoxemia during sleep, particularly since indirect observations suggest an increased mortality during sleep in this group of disorders. Consider sleep hygiene.
Poor sleep is often related to behaviors and habits that contribute to insomnia problems.
Surprisingly often, patients with chronic sleep problems violate one or more of these precepts, and correction of these behaviors substantially improves sleep. Although this condition is not specifically linked with chronic lung diseases, because of its high prevalence in middle-aged and elderly populations, the joint occurrence of OSA and COPD must be considered. Diagnosis requires a sleep study with relatively sophisticated technology to separate the effects of upper airway obstruction from those due to chronic lung disease and to identify the factors causing sleep disruption. Polysomnography would be clearly superior to limited home monitors, especially those in which oximetry is the principal signal. Consider restless legs and periodic leg movements.