Better sleep, better breathing: How sleep disorders impact COPD

On World Sleep day, 14 March 2025, we’re spotlighting critical link between sleep disorders and Chronic Obstructive Pulmonary Disease (COPD). Dr Chris Kosky, Clinical Associate Professor at the Institute for Respiratory Health, Sleep and Respiratory Physician at Sir Charles Gairdner Hospital, and Clinical Advisor for Respiratory Care WA, shares his insights into how sleep impacts COPD and what can be done to improve both.Better Sleep, Better Breathing: How Sleep Disorders Impact COPD

Sleep disorders are a major but often overlooked burden for people living with COPD. Studies show that up to 75 per cent of COPD patients struggle with disrupted sleep—whether it’s insomnia, obstructive sleep apnoea (OSA), or frequent nighttime awakenings due to coughing and breathlessness.

Sleep is just as essential as exercise and nutrition for good health. Poor sleep can worsen COPD symptoms, increase hospital admissions, and take a toll on mental wellbeing. But there is hope—effective treatments are available, and new advancements are opening even more possibilities for better sleep and better health.

Insomnia is common for people with COPD. Breathlessness, reduced activity, and social isolation can make falling and staying asleep a challenge. Anxiety about flare-ups or hospital admissions can also create a cycle of poor sleep and worsening symptoms.

The first step is ensuring COPD is well-managed with the right medication. When it comes to treating insomnia, Cognitive Behavioural Therapy for Insomnia (CBTi) is the gold standard—offering a better long-term solution than sleeping tablets.

“CBTi techniques like sleep retraining and relaxation therapy help break the cycle of anxiety and poor sleep. This leads to lasting improvements in rest and overall health,” Dr Chris Kosky said.

Research shows that up to 70 per cent of patients with insomnia experience improvements with CBTi. In Perth, services like Sleep Matters can assist with this sleep retraining, helping patients get back on track.

But insomnia isn’t the only issue. Obstructive Sleep Apnoea (OSA) is another major concern for people with COPD.

OSA affects around 30 per cent of adult men and 20 per cent of women, while COPD impacts 10 per cent of the global population. Many people experience both, creating a cycle where each condition worsens the other.

OSA is characterised by snoring and repeated pauses in breathing during sleep. These pauses, caused by airway collapse, lead to oxygen deprivation and increased strain on the heart, which can further aggravate COPD symptoms.

If a COPD patient snores or feels excessively tired during the day, a sleep study is recommended. These can be done through pharmacies, healthcare providers, or hospitals for more severe cases.

Treatments like Continuous Positive Airway Pressure (CPAP) therapy can be highly effective. CPAP helps keep airways open during sleep, improving breathing and reducing symptoms. Lifestyle changes like maintaining a healthy weight, reducing alcohol intake, and side-sleeping can also make a big difference.

While CBTi and CPAP therapy help many patients, they don’t work for everyone. For those still struggling, new therapies are showing promise.

At the Institute for Respiratory Health, Dr Kosky and his team are exploring advanced treatments, including biologic medications aimed at reducing inflammation and improving sleep and breathing.

One exciting development is Dupilumab, recently approved for COPD treatment. While it’s awaiting inclusion on the Pharmaceutical Benefits Scheme (PBS) in Australia, it offers hope for patients with severe symptoms. Other biologic drugs are also being trialled, targeting inflammation to reduce flare-ups and enhance quality of life.

As research continues to uncover the link between COPD and sleep disorders, one thing is clear—better sleep means better breathing and a better life.

With advances in treatments and greater awareness, there is hope for those facing sleep difficulties alongside COPD.

“Improving sleep in COPD patients isn’t just about rest—it’s about restoring their ability to live life to the fullest,” Dr Chris Kosky said.

This World Sleep Day, we encourage early diagnosis and proactive treatment. By raising awareness and improving access to effective therapies, we can help people with COPD breathe easier and sleep better.

Article written by Siaw Chai
Campaign Manager Respiratory Care
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