Studies have linked poor sleep with a worsening of COPD symptoms, as well as an increased risk of developing complications from the disease, according to the American Thoracic Society. Trouble is, it can be hard to fall asleep — and stay asleep — when you’re feeling short of breath, coughing, and in pain. Indeed, more than 75 percent of people with COPD report nighttime symptoms and difficulty sleeping, according to the Sleep Foundation. Some medications used to treat the condition can also make sleeping problems worse. Inhaled medications like theophylline 4 (Theo-24, Theochron, Elixophyllin) improve chest symptoms but can also reduce sleep quality for some people with COPD, per the Sleep Foundation. Prednisone can also affect your ability to sleep. Anxiety and depression, which often occur in people who have chronic conditions, can also cause or worsen insomnia in people with COPD, says E. Neil Schachter, MD, a pulmonologist and sleep medicine specialist at Mount Sinai Hospital in New York City. RELATED: 12 Ways to Breathe Better With COPD
Sleep Tips for People With COPD
The positive news is that there are a number of things you can do to improve your sleep when you have COPD. Here are some strategies to try:
1. Adjust Your Sleep Position
Sleeping in a slightly upright position will take some stress off your lungs, says MeiLan K. Han, MD, a professor of medicine in the division of pulmonary and critical care at the University of Michigan in Ann Arbor and a spokesperson for the American Lung Association. Slightly elevating your head also helps prevent acid reflux (when stomach acid backs up into your esophagus) from waking you up at night. Known as gastroesophageal reflux disease (or GERD), this condition is common in people with COPD. According to a review published in May 2018 in the journal Chest, simple behavioral changes including proper positioning (to take pressure off the esophagus and allow gravity to keep acid down) can improve nighttime GERD symptoms, as well as sleep quality.
2. Avoid Napping During the Day
If you absolutely need a nap, keep it short — no longer than 30 minutes — and avoid napping in the late afternoon. A short nap can restore energy, but a long or late nap can keep you awake at night and worsen the cycle of poor sleep and excessive daytime sleepiness, notes the Sleep Foundation.
3. Unplug From Electronics
Build in a 30- to 60-minute device-free buffer before bed. Cell phones, tablets, and laptops cause mental stimulation that is hard to shut off, notes the Sleep Foundation. In addition, the blue light from screens suppresses production of the sleep-inducing hormone melatonin, which can make it harder to drift off. If you must look at a screen within an hour of bedtime, set your device to “night mode” to minimize the impact of the light.
4. Be More Physically Active During the Day
“Exercise is something that improves COPD in general,” Dr. Schachter says. In fact, a moderate exercise routine can improve your body’s use of oxygen, reduce your shortness of breath, increase your energy and muscle strength, reduce anxiety and depression, and aid sleep, says the American Lung Association (ALA). “[Being physically active] improves your endurance so that you can do more during the day, and if you do more during the day, you will sleep better at night,” adds Schachter.
5. Try Some Yoga
Yoga is a great form of exercise for people with COPD because it reduces stress and also helps you control your breathing, says Martha Cortés, DDS, a dental and sleep disorders specialist in New York City. A study published in May 2021 in the journal Complementary Therapies in Clinical Practice 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 — even on weekends — can get your brain and body accustomed to getting the full amount of sleep you need, says the Sleep Foundation. Also, try to follow the same pre-bed ritual — such as washing up, putting on PJs, and doing something relaxing, like reading, stretching, or meditation, for 30 minutes. This helps reinforce in your mind that it’s bedtime, making it easier to fall asleep.
7. Talk to Your Doctor About Using Oxygen Therapy
People with lung diseases lose oxygen in their blood overnight, especially during REM sleep (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, says the ALA. “If you need it, it’s important that you be prescribed nocturnal oxygen,” Schachter says. While some people with COPD need oxygen, for a small percentage it can be dangerous, so make sure you have a thorough discussion with your doctor about using oxygen therapy. RELATED: What Are the Four Stages of COPD and the Gold System for Grading?
8. Make Your Bedroom a Haven for Sleep
Keeping the bedroom quiet, dark, and cool can help you nod off. Consider buying light-blocking shades or using an eye mask to keep any light (including streetlights and early morning light) from entering the room, Dr. Cortés advises. “Also, make sure your bed is big and comfortable enough to promote rest, especially if there are two of you,” she adds. You may also want to use ear plugs or a white noise machine to drown out any sounds, and keep the temperature on the cooler side — around 65 degrees Fahrenheit is ideal, the Sleep Foundation says.
9. Get Tested for Sleep Apnea
If you have any signs and symptoms of sleep apnea — say, for example, your partner notices that you’re snoring a lot or sometimes gasp for air — ask your doctor about scheduling a test for this sleep disorder. Sleep apnea, which occurs in about 10 to 15 percent of people with COPD, causes oxygen levels in the blood to drop and interrupts the sleep cycle, says the COPD Foundation. It can also cause other serious problems if left untreated. The condition can be effectively treated by wearing a nasal continuous airway pressure device (i.e., CPAP) 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, Schachter says. Also, let your doctor know if pain from COPD keeps you awake. Pain is very disruptive to sleep, notes Dr. Han, so it’s important to talk to your doctor about ways to manage it at night.
