[Sleep and respiration]

Nocturnal sleep-associated breathing disorders have only been investigated thoroughly since about 15 years. From these studies it became clear that many respiratory disorders, in particular chronic obstructive ones, may severely impair nocturnal breathing and thus oxygen supply. by physiologically reduced ventilation at night, particularly in patients with already reduced pulmonary function, oxygen supply may become insufficient. In order to prevent late sequelae, early invalidity or precocious death, a comprehensive diagnostic approach is mandatory. Therapy consists of thorough anti-obstructive and anti-inflammatory inhalations, aided by additional oxygen supply during the night sleep in selected cases. Sleep-apnea syndrome is a frequent disease. About 3%, of males between 25 and 75 and at least 1% of females particularly after menopause, are affected. In most cases diagnosis can be suspected by clinical symptoms and nocturnal pulse oximetry. Sensitivity of pulse oximetry, however, is insufficient, thus polysomnography is necessary to establish the diagnosis and to control therapy. The most important therapeutic measure is to establish a nocturnal nasal continuous positive airway pressure (nCPAP) that may lead to immediate amelioration of symptoms and may normalize survival of patients. In particular, patients with obstructive sleep apnea should not drive motorized vehicles because of their excessive daytime sleepiness until a therapeutic success is evident. In this paper chronic obstructive pulmonary diseases, the central and the obstructive sleep-apnea syndrome are covered in particular.