Nächtliche Bronchialobstruktionen und Schlaf - Ergebnisse von akustischer Langzeitregistrierung und Polysomnographie

Die Bedeutung eines erholsamen Schlafs für die Gesundheit ist gesichert. Leistungsfähigkeit und Erholungsfunktion des Schlafes sind an das synchron ablaufende Wechselspiel der Funktionen Wachen und Schlafen gekoppelt. Eine Störung des zirkadianen Rhythmus der Schlaf/Wachphase führt vor allem zu eine...

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Bibliographic Details
Main Author: Reinke, Christian
Contributors: Koehler, Ulrich (Prof. Dr.) (Thesis advisor)
Format: Dissertation
Published: Philipps-Universität Marburg 2005
Innere Medizin
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Table of Contents: The importance of a restful sleep for the health is certain. Fitness and recovery while sleeping are related to the synchronous course of interplay of the functions awake and sleep. A disturbance of the circadian rhythm of the sleep/awake phase leads above all to a reduction of psychomental fitness. This appears in increased daytime sleepiness, lack of drive, lack of concentration and changes of tone. Patients with obstructive pulmonary diseases often complain of respiratory trouble in sleep. Therefore the aim of this study was to make possible more precise assessment of the interaction between bronchial obstruction and sleep parameters. In this study 20 patients (9 men and 11 women) with bronchial asthma / COPD as well as a clinical acoustical bronchial obstruction were included. All were measured prospectively through the night with a cardiorespiratory polysomnography combined with a recording of the lung sounds with the PulmoTrack© Model 1010. The mean age of the patients was 55.4±12.4 years (mean±SD, range 23 to 74 years). In all 20 patients the sleep structure was disturbed. Reduced values were found for total sleep time (312±110 min), sleep efficiency (66±21%) and REM sleep (16±7%). In four patients an obstructive sleep apnoea was newly diagnosed moreover (RDI>=10/h). All patients had nocturnal acoustical bronchial obstructions. The wheezing duration reached from 30 seconds to 317 minutes. The wheezing detection of the PulmoTrack© worked good and reliable. For the thoracal measured obstructions there was a statistical tendency for a correlation between increased wheezing and increased vigilance (p<0.1). For the tracheal measured obstructions there was no significant result. The frequency of central waking reactions during bronchial obstructions was increased in tendency (p<0.1). Further studies with greater and more standardized patient collectives are needed to answer the question of the pathophysiological correlation between bronchial obstructions and sleep parameters. The long term recording of lung sounds is a good and efficient method for the assessment of bronchial obstructions. In future it can serve for the assessment of the antibronchial therapy efficiency in patients with bronchial asthma and COPD.