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MEDICAL CAUSES OF INSOMNIA: ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Asthma

Asthma frequently attacks at night, causing victims to awaken with wheezing, coughing, and shortness of breath. A combination of circadian rhythms, each reaching its respective high or low point, is thought by many researchers to trigger these nocturnal attacks. Other sleep factors, including the horizontal position and the physiologic changes that accompany the-REM sleep phase, may also play a role. Inhaled drugs called bronchodilators can widen bronchial passages and quickly alleviate the symptoms. Long-lasting medications are now being marketed which are designed to reach their peak of therapeutic activity during the early hours of the morning, when the risk of an asthma attack seems to be the greatest.

Chronic Obstructive Pulmonary Disease (COPD)

COPD is a general name for several conditions that prevent normal breathing and interrupt sleep. These conditions include emphysema, chronic bronchitis, and abnormally developed airways. Usually the symptoms—difficulty breathing on exertion, coughing, wheezing, and frequent respiratory infections—begin to appear in middle age, although the disease itself may be present for years before symptoms develop. Often the first sign is a mild "smoker's cough." Usually COPD is not curable, but treatment can relieve symptoms and control the dangerous, and sometimes fatal, exacerbations of the disease. Therapy depends on the exact nature of the illness and may involve drugs, inhalation therapy, exercise, and supportive therapy.

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