COPD and Sleep

With COPD, there are lots of things that can make it difficult for you to get a good night’s sleep. These include having to sleep sitting up or taking medications that either “rev you up” or cause you to have to use the restroom frequently during the night. Emotional changes, such as depression and anxiety, can also impair your sleep. Most of the sleep problems related to COPD can be helped, so it’s a good idea to discuss your sleep problems with your doctor. Here are some questions to think about:

How would you describe your usual night’s sleep (number of hours, overall quality)?
Do you have trouble falling asleep when you first go to bed?
Do you wake up during the night? If so, what wakes you up and are you able to easily fall back to sleep?
Do you wake up too early in the morning? How long have you had difficulty sleeping? What do you think caused the problem?
What have you done to try to improve your sleep?

While your doctor may prescribe medication to help you sleep, there are steps you can take – without using any medication – that may help you get a better night’s sleep.

What are some suggestions to help me sleep better?

You should only do two things in bed: sleep, and make love.

So, if you are not doing one of these you should not be in bed. The most important rule is to avoid being in your bed awake. If you are having difficulty sleeping:

Don’t watch TV in bed, don’t read, and don’t just lie there watching the clock change.
If you find yourself awake, watching the clock for more than 20 minutes, GET UP! Make yourself a cup of warm milk or herb tea (NOT black or green tea since these have caffeine) and do something relaxing (even if it’s a little boring) – read a magazine, watch old sitcoms in another room, just look out the window.
When you feel “the edge” starting to come off, return to bed and try again. When you return to bed if you’re not asleep in 20 minutes, GET BACK UP! If you can’t get sleep the second time around, think of a low-energy chore you have wanted to get done (like putting your photos into albums or cleaning out the “junk drawer”) and DO IT. You might not have gotten a full night’s sleep, but you will have done something that you have been meaning to do. Furthermore, the next night your body should be more tired and ready for sleep. If you don’t sleep well that second night, talk to your doctor; be sure to bring in the answers to the questions you just answered.
The goal of this suggestion is to teach your body that if you’re horizontal you should be falling asleep soon. Therefore, it’s important that you don’t lie down on the sofa to watch TV, talk on the phone, read, etc.
Try to avoid napping; if you don’t nap, you’re more likely to be tired enough at bedtime to fall asleep.
Try to get at least 30 minutes of exercise at least three times a week. This can be as simple as walking steadily.
Don’t do anything too stimulating in the two hours before you go to bed. During this time, try to avoid exercising, arguing with someone, working, etc.
Try not to go to bed hungry, but also don’t eat a big meal or a lot of carbohydrates just before going to bed. Instead, have a small, high-protein snack such as cheese and crackers, a glass of milk, or some nuts.
Keep your sleep environment conducive to sleep – cool, dark, and quiet.
You’ll sleep better if your feet are warmer than your head – wear socks.
Limit caffeinated beverages within four to five hours of bedtime (none after 5 pm).
Try to keep regular bedtime and wake-up times.

Difficulty with sleep is very common, with or without COPD. When you have difficulty falling asleep, be patient with yourself and don’t let your frustration get the better of you. Getting angry and anxious will only make the problem worse. Accepting that on a given night you might have more trouble sleeping than you’d like may help you get back to sleep sooner.

If you or someone you love is struggling with sleep problems, National Jewish can help. The Sleep Center at National Jewish is the oldest and most comprehensive sleep medicine program in the Denver region.

This information has been approved by Rachel Norwood, MD (September 2006).