Sleep disordered breathing in hospitalized patients

摘要

Sleep is a ubiquitous phenomenon that is both adaptive and restorative. Obstructive sleep apnea, obesity-hypoventilation syndrome, primary central sleep apnea, and Cheyne-Stokes breathing/complex sleep apnea are the most common sleep-related breathing disorders encountered in the hospitalized population. Sleep disordered breathing (SDB) is commoner in hospitalized patients with obesity, congestive cardiac failure, COPD, and osteoarthritis. Various hospital and ICU-related factors contribute to disruption of sleep architecture and circadian rhythm. Sleep deprivation has been linked to higher incidence of delirium, prolonged hospitalization, and mortality during the hospital stay and long-term cognitive impairment. Persistent sleep deprivation also causes impairment in immune response. There is now a conclusive body of evidence linking SDB with higher prevalence of cardiovascular disease, stroke, diabetes, perioperative complications, and worse outcome. Hence, early recognition and treatment of SDB has become important for patients admitted in medical wards, critical care units, and post-surgical wards.