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Nocturnal ventilatory support in COPD

Peter C Gay, MD
Section Editor
James K Stoller, MD, MS
Deputy Editor
Helen Hollingsworth, MD


Nocturnal alterations in gas exchange, such as oxygen desaturation and hypercapnia, are an important clinical problem in patients with chronic obstructive pulmonary disease (COPD). Potential forms of treatment include supplemental oxygen, pharmacologic agents, and nocturnal ventilatory support. (See "Sleep-related breathing disorders in COPD".)

The use of nocturnal ventilatory support in the management of patients with stable COPD will be reviewed here. The management of acute exacerbations of COPD and sleep-related breathing disorder in COPD are discussed separately. (See "Noninvasive ventilation in acute respiratory failure in adults" and "Sleep-related breathing disorders in COPD".)


It has been hypothesized that nocturnal noninvasive ventilation can improve both nocturnal and daytime respiratory function in patients with advanced COPD by providing periods of rest for weakened respiratory muscles. The evidence related to this hypothesis is of limited quality and conflicting, as described below [1-7].

Respiratory muscle weakness in chronic obstructive pulmonary disease (COPD) probably results from a number of factors including the following [1]:

Change in configuration of the diaphragm caused by hyperinflation


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Literature review current through: May 2017. | This topic last updated: Sep 28, 2015.
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