Chronic Obstructive Pulmonary Disease (COPD) is a an obstructive disease of the lungs. The lung tissue has been so destroyed, that it's difficult for it to exchange gas, leading to a decreased oxygen level and difficulty breathing. It can be extremely difficult to breathe at night, partly due to the fact that the lungs are laying flat on the back of the chest wall making it more difficult to breathe. This can lead to nighttime wheezing and sleep disturbances. Here are some tips for improving sleep with COPD. 

1. Adjust your sleep position 

Sleeping in a somewhat upright position may take some stress off of your lungs. If you can prop yourself up on some pillows, that can allow gravity to work in a way that favors gas exchange, making it a little easier to breathe.

It also helps to prevent acid reflux which is when stomach acid backs up into your esophagus which is also something that can wake you up at night. This is known as GERD which is a common condition in those with COPD. Proper positioning as well as changing nighttime eating routines can help improve nighttime GERD symptoms and sleep quality. 

2. Avoid napping during the day 

If you really need a nap during the day, keep it short and avoid sleeping in the late afternoon. A short nap can restore energy, but a long nap can keep you awake at night and add to the burden of nighttime sleep issues. 

3. Unplug from electronics 

Build in a 30 - 60 minute device-free buffer before bed. Cell phones, tablets and laptops cause mental stimulation that can be difficult to shut off in time to go to bed. Also the blue light from screens suppresses melatonin release, making it harder to drift off. If you must look at a screen before bed, turn it to a night mode to minimize the impact of the light. 

4. Be more physically active during the day 

Exercise benefits COPD in general and can improve your body's use of oxygen, reduce your shortness of breath, increase your energy and muscle strength, reduce anxiety and depression. Activity helps to boost endurance during the day and if you can do more during the day, you can sleep better at night. 

5. Try some yoga 

Yoga is a great form of exercise for those with COPD. Sometimes, the symptoms of COPD are so great, that exercise can be difficult. However, Yoga reduces stress and helps to control breathing. One study found that yoga can reduce the severity of shortness of breath and fatigue and improve sleep in people with chronic respiratory diseases such as COPD. 

6. Establish a consistent sleep routine 

Going to bed and waking up at about the same time every day, including weekends, can get your brain and body used to getting the full amount of sleep that you need. Also, if you can establish sleep hygiene, or a pre-bed routine, then that can also help train your mind and body on when it's time to go to bed. These activities can include showering, baths, reading, stretching or meditating. 

7. Talk to your doctor about using oxygen therapy 

People with long disease lose oxygen in their blood overnight, especially during rapid eye movement (REM) sleep which is when dreaming takes place. Using oxygen therapy at night allows your body to get more oxygen into the bloodstream and can help you get a better night's sleep. Most of the time oxygen can be helpful, but for a select few, it can actually be fairly dangerous. Consult with a professional before starting any sort of oxygen therapy. 

8. Make your bedroom a haven for sleep 

Your sleeping environment is important for getting optimal sleep. If you sleep in a quiet, dark and cool room, this can be great for helping you nod off. Even consider buying blackout curtains to make sure no light enters your room so you can sleep throughout the night without any disruptions. Your bed comfort is important too. Having a comfortable mattress and sheets can really help you improve sleep. 

9. Get tested for sleep apnea 

Get tested for sleep apnea. If you have any symptoms of sleep apnea like excessive snoring, cessation in breathing throughout the night, or excessive daytime sleepiness, then ask your doctor about scheduling a test for this sleep disorder. 

Sleep apnea, which occurs in about 10-15% of people with COPD causes oxygen levels in the blood to drop and interrupts the sleep cycle. It can cause other serious problems if left untreated. The condition can be effectively treated by wearing a nasal continuous airway pressure device while you sleep, which gently forces air through your nose to keep the airway open. 

10. Review your medications 

Talk to your doctor about all of the medications you take and ask whether any of them are causing you to lose sleep. You may be able to adjust the time you take them to prevent them from keeping you awake at night. Also let your doctor know if pain from COPD interrupts your sleep. Pain is very disruptive, so it's important to be able to manage it at night. 

If you continue to having issues sleeping, it's important to talk with your PCP about your COPD, but you can also click the orange button below to take a free online sleep test and speak with a sleep professional. 

Resources: 

https://www.everydayhealth.com/hs/managing-copd/sleep-tips-for-copd/