The use of noninvasive ventilation (NIV) in patients with moderate to severe, stable chronic obstructive pulmonary disease (COPD) while they were asleep has been shown to increase rapid eye movement (REM) sleep time, decrease sleep onset latency, the number of obstructive respiratory events, and the mean and maximum heart rate (HR). Researchers conducted a current cross-sectional pilot study at the Respiration Laboratory (RespLab) in the Department of Internal Medicine of the Federal University of Ceará in Fortaleza, Brazil, with results published in the journal Sleep Medicine.
Investigators sought to assess the acute effects of NIV compared with spontaneous breathing on sleep latency and sleep stages, as well as on the occurrence of sleep-related respiratory events, nocturnal hypoxemia, and changes in HR among individuals with moderate to severe, stable COPD. All of the participants completed 2 polysomnography (PSG) studies — one during spontaneous breathing and the other while receiving NIV in bilevel mode and with a backup respiratory rate setting. The primary study outcome was the effect of NIV on sleep latency, on sleep stages, and on the occurrence of respiratory events during sleep. A total of 10 women were enrolled in the study. The mean patient age was 68.1±10.2 years.
Results of the study showed that NIV during sleep significantly decreased sleep onset latency (17.0±18.8 min vs 46.8±39.5 min; P =.02), increased REM sleep time (41.2±24.7 min vs 19.7±21.7 min; P =.03), and significantly decreased the obstructive apnea index (0 vs 8.7±18.8; P =.01). Further, both significantly lower mean HR (66.6±4.1 bpm vs 70.6±5.9 bpm; P =.03) and significantly lower maximum HR (84.1±7.3 bpm vs 91.6±7.8 bpm; P =.03) were seen in PSG with NIV.
The investigators concluded that based on the fact that this is a pilot study, they intend to continue their research via a longitudinal study with a larger sample and a control group. Therefore, additional randomized controlled analyses are warranted to ascertain the real benefits of nocturnal NIV on quality of sleep among patients with COPD and the importance of adequate settings of ventilator parameters.
Lino JA, Vasconcelos RDS, Gomes GC, et al. Acute effects of noninvasive ventilation on sleep physiology in patients with moderate to severe stable chronic obstructive pulmonary disease: a pilot study. Sleep Med. 2021;80:118-125. doi:10.1016/j.sleep.2021.01.049