Pulmonary Diseases

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) mainly includes chronic bronchitis and emphysema. COPD is a category of lung diseases characterized by chronic obstruction of lung air flow that interferes with normal respiratory function. COPD is not fully reversible but may be prevented and can be treated.

For example, with chronic bronchitis, the lining of the breathing tubes become swollen and produce excessive mucus that gets coughed up. With emphysema the walls of the air sacs in the lung are broken down and the air spaces get larger and air gets trapped. Some people have both chronic bronchitis and emphysema, consequently, most cases are referred to as COPD.

Pulmonary Fibrosis

Pulmonary fibrosis occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. With worsening of pulmonary fibrosis shortness of breath is progressive.

The scarring associated with pulmonary fibrosis can be caused by a multitude of factors. However the clear causes can not be conceptualized. When a cause is undetermined, the condition is termed idiopathic pulmonary fibrosis.

The lung damage caused by pulmonary fibrosis usually appears irreversible, but medications and therapies may sometimes help ease symptoms and improve quality of life.

Source: Mayo Clinic

Pulmonary Hypertension

Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of your heart. Pulmonary hypertension causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity.

Pulmonary hypertension begins when tiny arteries in your lungs, called pulmonary arteries, and capillaries become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, and raises pressure within your lungs' arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and eventually fail.

Pulmonary hypertension is a serious illness that becomes progressively worse and is sometimes fatal. Although pulmonary hypertension is unlikely curable, treatments are available that can help lessen symptoms and improve wellbeing.

Sources: Mayo Clinic and National Heart Lung and Blood Institute

Abnormal Chest X-Ray

Abnormal chest X-Ray are abnormalities on the lung radiographic exam that drop out of the normal range. For example, nodules, tumors, all types of pneumonias, enlarged lungs, small lungs, collapsed areas of the lung, different kinds of opacities or shadows, narrow airway passages, and so forth. Patients with abnormal chest X-Ray are evaluated thoroughly by a pulmonologist who will discuss further testing and treatment guidance.


Asthma is a chronic disease that affects the airways. It is characterized by sore, swollen and subsequent narrowing of the airways. This can cause wheezing, coughing, chest tightness, and difficulty breathing. Asthma is diagnosed in the appropriate clinical setting which will include medical history, physical exam, and pulmonary function testing. Treatment guidelines are provided based on the severity of asthma. With adherence to treatment, asthma is a reversible disease.

Sleep Disorders

Sleep Apnea

The Greek word "apnea" literally means "without breath." Sleep apnea is an involuntary cessation of breathing that occurs while the patient is asleep. There are three types of sleep apnea: obstructive, central, and mixed. Of the three, obstructive sleep apnea, often called OSA for short, is the most common. Individuals with untreated sleep apnea stop breathing repeatedly during their sleep without being aware of it. A major symptom is extremely loud snoring, so loud that bed partners find it intolerable. Other indications that sleep apnea may be present are obesity, persistent daytime sleepiness, bouts of awakening out of breath during the night, and frequently waking in the morning with a dry mouth or a headache.

Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed sleep apnea, as the name implies, is a combination of the two. With each apnea event, the brain rouses the sleeper, usually only partially, to signal breathing to resume. As a result, the patient's sleep is extremely fragmented and of poor quality.

Source: American Sleep Apnea Association


Insomnia is a common sleep disorder. Individuals who have insomnia have trouble falling asleep, staying asleep, or both. As a result, people with insomnia feel unrefreshed and not restful due to poor-quality sleep. Insomnia can be acute (short-term) or chronic (ongoing).

Acute insomnia is common and often is brought on by situations such as stress at work, family pressures, or a traumatic event. Acute insomnia lasts for days or weeks. Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary, meaning, as a result of other medical problem. Certain medical conditions, medicines, sleep disorders, and substances may cause secondary insomnia.

In contrast, primary insomnia is a distinct disorder without a clear cause although several live changes may trigger primary insomnia, including long-lasting stress and emotional upset.

Insomnia may cause daytime sleepiness and a lack of energy. Additional symptoms may include feeling anxious, depressed, or irritable. Also, trouble focusing on tasks, paying attention, learning, and remembering may occur.

Source: National Heart Lung and Blood Institute

Restless Legs Syndrome

Restless legs syndrome (RLS) is a disorder of the nervous system that affects the legs and causes an urge to move them. Because it usually interferes with sleep, RLS is considered a sleep disorder.

People with restless legs syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations. The sensations of RLS have been mostly referred to as "uncomfortable," "itchy," "pins and needles," or "creepy crawly" feeling in the legs. The sensations are usually worse at rest, especially when lying or sitting and can lead to sleep deprivation and stress.

The severity of RLS symptoms ranges from mild to intolerable. Symptoms can come and go and severity can also vary. The symptoms are generally worse in the evening and at night and less severe in the morning. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair a person's quality of life.

Source: WebMD


Narcolepsy is a chronic disorder of the central nervous system characterized by the brain's inability to control sleep-wake cycles. At various times throughout the day, people with narcolepsy experience irresistible and sudden bouts of sleep, which can last from a few seconds to several minutes.

In narcolepsy, sleep episodes can occur at any time. People may unwillingly fall asleep while at work or at school, when having a conversation, playing a game, eating a meal, or, most dangerously, when driving an automobile or operating other types of machinery. In addition to daytime sleepiness, other major symptoms include cataplexy (a sudden loss of voluntary muscle tone that may be triggered by strong emotions), vivid dream-like images or hallucinations during sleep onset or when waking, and brief episodes of total paralysis, also during sleep onset or when waking. The loss of muscle tone in cataplexy and sleep paralysis involves the simultaneous loss of both extensor reflexes (such as a knee tap and resulting leg jerk) and flexor reflexes (such as lifting the foot and/or leg following a foot prick or stepping on a sharp object). Normally, this kind of reflex loss exists only during rapid eye movement (REM) sleep.

Contrary to common beliefs, people with narcolepsy do not spend a substantially greater proportion of their time asleep during a 24-hour period than do normal sleepers. In addition to daytime drowsiness and uncontrollable sleep episodes, most individuals also experience poor sleep quality that can involve frequent awakenings during nighttime sleep, and other sleep disorders. For these reasons, narcolepsy is considered to be a disorder involving the loss of control of the normal boundaries between the sleeping and waking states.

Source: National Institute of Neurological Disorders and Stroke

Circadian Rhythm Disorders

Circadian rhythm disorders are characterized by an abnormality in levels of wakefulness and sleepiness. These levels are regulated by a central circadian clock located in the central nervous system. Symptoms may include tiredness, sleepiness, insomnia, loss of energy, irritability, and social withdrawal. Circadian rhythm disorders may be due to, jet lack, shift worker, delayed and advanced sleep phase syndrome. Effective treatments aim at regulating the sleep cycle and include sleep diary, actigraphy, light therapy, and specific medications.


Sleepwalking, formally known as somnambulism, is a behavior disorder that originates during deep sleep and results in walking or performing other complex behaviors while asleep. Usually more common in children than adults and is more likely to occur if a person is sleep deprived. Because a sleepwalker typically remains in deep sleep throughout the episode, he or she may be difficult to awaken and will probably not remember the sleepwalking incident.

Sleepwalking usually involves more than just walking during sleep; it includes a series of complex behaviors that are carried out while sleeping, the most obvious of which is walking.

Symptoms of sleepwalking disorder range from simply sitting up in bed and looking around, to walking around the room or house, to leaving the house and even driving long distances. A common misconception is that a sleepwalker should not be awakened. In fact, it can be quite dangerous not to wake a sleepwalker.

The prevalence of sleepwalking in the general population is estimated to be between 1% and 15%. The onset or persistence of sleepwalking in adulthood is common, and is usually not associated with any significant underlying psychiatric or psychological problems. Common triggers for sleepwalking include sleep deprivation, sedative agents (including alcohol), febrile illnesses, and certain medications.

The prevalence of sleepwalking is much higher for children, especially those between the ages of three and seven, and occurs more often in children with obstructive sleep apnea. There is also a higher instance of sleepwalking among children who wet the bed. Sleep terrors are a related disorder and both tend to run in families.

Source: National Sleep Foundation