Skip to main content Accessibility help
×
Home
  • Print publication year: 2008
  • Online publication date: August 2009

11 - Sleep and medical disorders

from SECTION 3 - SLEEP IN SPECIALTY AREAS

Summary

This chapter describes both the impact of medical diseases and their treatments on sleep, and how disordered sleep can contribute to medical illnesses. Airway function has a normal circadian variation, with peak airflow in the afternoon and the lowest in the early morning. In people with asthma, this morning trough is associated with worsening of asthma symptoms and sleep disturbance. In individuals with heartburn at least once weekly, three-quarters complain of heartburn affecting their sleep. Polysomnography helps to clarify the nature and severity of the primary sleep disorder and aid in the management of end-stage renal disease (ESRD). Disruption of sleep is common in people with arthritic or muscular pain. Pain, sleep disturbance, and low mood are all believed to contribute to fatigue, a common complaint of those with rheumatic disorders. Circadian sleep/wakefulness is intricately linked to neuroendocrine and neuroimmune functions.
FURTHER READING
Celli, BR, MacNee, W, ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23:932–46.
DeVault, KR, Castell, . Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 2005; 100:190–200.
Goldenberg, DL, Burckhardt, C, Crofford, L. Management of fibromyalgia syndrome. JAMA 2004; 292:2388–95.
Gula, LJ, Krahn, AD, Skanes, AC, Yee, R, Klein, GJ. Clinical relevance of arrhythmias during sleep: guidance for clinicians. Heart 2004; 90:347–52.
Kryger, MH, Roth, T, Dement, WC, eds. Principles and Practice of Sleep Medicine, 4th edn. Philadelphia, PA: Saunders, 2005.
Lemmer, B. Relevance for chronopharmacology in practical medicine. Semin Perinatol 2000; 24:280–90.
Martin, RJ, Banks-Schlegel, S.Chronobiology of asthma. Am J Respir Crit Care Med 1998; 158: 1002–7.
Parker, KP. Sleep disturbances in dialysis patients. Sleep Med Rev 2003; 7:131–43.