Sleep disturbances in respiratory and cardiovascular disease

It has long been recognised that patients with respiratory and cardiac disease suffer from symptoms during the night when they would normally be seeking respite. These disturbances include nocturnal dyspnea, cough, wheezing and angina. Until the advent of polysomnographic monitoring about 25 yr ago, however, the pathophysiology of these nocturnal disturbances remained elusive. Since that time, investigators have made significant advances in the understanding of the pathogenesis of many of these disturbances which will be briefly reviewed below. As the subject of this article is disturbances of sleep in patients who suffer from respiratory and cardiac disease, the sleep apnea syndromes which are unique to sleep, will not be discussed except as they may contribute to symptoms of respiratory and cardiovascular disease.