Why COPD Makes It Hard to Sleep

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portrait of senior African American male sleeping in bed on side

Twelve million people in the United States have been diagnosed with chronic obstructive pulmonary disorder (COPD), a chronic condition in which airflow is obstructed in the lungs, making it harder to breathe. As a result, people with COPD don’t get enough oxygen, which can make them feel very fatigued. On top of that, COPD symptoms can also make it harder to get a good night’s sleep; in fact, half of people with COPD struggle with sleep issues. These problems include trouble falling asleep, waking up often, daytime sleepiness, and other forms of insomnia. Sleep problems can occur with COPD for a few different reasons. Learn how COPD can contribute to sleep problems and what to ask your doctor about sleeping better with COPD.

Sleeping With COPD: Disruptive Symptoms

COPD spans a group of lung conditions, including emphysema, chronic bronchitis, and chronic asthma. The following symptoms can make it hard to fall asleep and sleep through the night restfully:

  • Trouble breathing

  • Chronic cough

  • Tight feeling in the chest

As COPD progresses, these symptoms can get worse, making it even harder to sleep. Controlling COPD symptoms with medications and therapies can help, as well as stopping tobacco use and addressing any feelings of anxiety and depression that often come with a chronic condition. It’s a lot to consider, but your healthcare team is there to help you deal with all aspects of COPD,  from teaching breathing exercises to strengthen your lungs and get more oxygen, to counseling and medication to help you stop smoking, to psychiatric support for improving your mood. When your COPD is controlled and you’re better able to breathe, you’re also better able to sleep soundly.

Overlap Syndrome: COPD and Obstructive Sleep Apnea (OSA)

Two of the most common pulmonary conditions are COPD and OSA, and they’re both characterized by disordered breathing. With OSA, breathing stops repeatedly during the night for a period of about 10 seconds. Between 10 and 15% of those with COPD have OSA, too. Having both conditions is known as “overlap syndrome,” and it comes with a double whammy of breathing problems.

Those who have the syndrome don’t get enough oxygen at night, which can cause severe fatigue during the day. Doctors often recommend continuous positive airway pressure (CPAP) machines, a common treatment for OSA, to ease the effects of overlap syndrome and improve lung function. This treatment involves sleeping while wearing a face mask that pumps air into your nose or mouth to open your airways and receive more oxygen. Supplemental oxygen therapy may also be suggested. Treating overlap syndrome can mean getting better quality sleep and more oxygen every night.

The Connection Between COPD Medications and Sleep Problems

Some―but not all―of the most effective medications for treating COPD symptoms have potential side effects that may cause sleep problems. These include some aerosol therapies, which are medications delivered through an inhaler. You may be more familiar with them as short-acting and long-acting bronchodilators or inhaled corticosteroids.

Certain sedatives such as benzodiazepines prescribed as sleep aids for those with COPD can also backfire by interfering with lung function. If you have COPD, consult your doctor before taking a sleep aid, even if it’s non-prescription or advertised as “natural.”

Every treatment for a chronic condition comes with benefits and risks. Maintain an ongoing dialogue with your doctor about what’s working for you, what isn’t, and what more can be done to live your best life with COPD. Many advances have been made to help you breathe–and sleep–easier.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Apr 1
  1. Management of insomnia in patients with chronic obstructive pulmonary disease. US National Library of Medicine National Institutes of Public Health. https://www.ncbi.nlm.nih.gov/pubmed/12558460
  2. COPD and Difficulty Breathing. National Sleep Foundation. https://www.sleepfoundation.org/articles/copd-and-difficulty-breathing
    Insomnia in Patients with COPD. US National Library of Medicine National Institutes of Public Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274338/
  3. When sleep apnea and COPD meet: Overlap Syndrome. American Sleep Apnea Association. https://www.sleepapnea.org/when-sleep-apnea-and-copd-meet-overlap-syndrome/
    Sleep Apnea and COPD: What You Should Know. COPD Foundation. https://www.copdfoundation.org/COPD360social/Community/COPD-Digest/Article/66/Sleep-Apnea-and-COPD-What-You-Should-Know.aspx
  4. Practical problems with aerosol therapy in COPD. US National Library of Medicine National Institutes of Public Health. https://www.ncbi.nlm.nih.gov/pubmed/16441960
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