500
HLAVNÍ42522001005185134178232252
TÉMA69222001003981147194
Nespavost42533001005187116154189225263293320
u761330010037
pacientů81433001003772103118153191218257
s1087330010028
chronickou11313300100296791130168183213248285323
obstrukční147133001003776105132157196230260298313
plicní1800330010037536898136151
nemocí:196833001003672132171202217232
patofyziologie,22163300100377299137157196229244283299338376392427441
diagnostika26743300100375287125163202231258274309344
a3034330010034
léčba30843300100155082120155
30018522001003480125
|350220010019
VNITŘNÍ4268040010746106127172220280301
LÉKAŘSTVÍ748804001074185130188236280325378400
/11948040010731
Vnitř1270804001074693112140166
Lék.1456804001074083122140
2026;72(5):300-3051615804001074487129171186227271292334357372416460505535576620663
/23238040010731
www.casopisvnitrnilekarstvi.cz442680400107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
https://doi.org/10.36290/vnl.2026.05642544001003865941331631802022236484400100418310274944001001554791171398904400100287389124167204247293316355396414432470516552594611655690733
Nespavost42598002751522703745036247478699721061
u15639800275122
pacientů17329800275123245345411529658747876
s2685980027599
chronickou28319800275962243174435716367378649871114
obstrukční4022980027512124935344153566278888610141080
plicní42512400275123189255356484551
nemocí:105312400275122241428554655721790
patofyziologie,192012400275123244334459550682788853979104411711298136514831553
diagnostika35501240027512418931143956769379788595210781199
a482612400275116
léčba49901240027560179280409530
Milan4251630013793124154213277
Sova,7251630013759123180237267
Jaroslav10141630013745103145209257287346403
Vejrych,14391630013770123155197257306371400
Vladimír18611630013770101159225255350380422
Herout,23061630013775134177240305346376
Ondřej27041630013779145210253311343
Venclíček30691630013770124189239270300349407467
Klinika425178001336087111172197247301
nemocí7491780013362117208268318343
plicních1115178001336389113162222247296356
a14941780013353
TBC,15711780013354114178202
Fakultní17961780013354102153213239275335360
nemocnice21791780013361116208268318378403452505
Brno2708178001335995156216
Insomnie425229001212480120177261317342393
je842229001212475
samostatná941229001214090174230270305355389445494
porucha14592290012157114148204250306355
spánku1838229001214097147203251307
a21692290012148
bdění,22412290012157116167223247269
která2534229001214784134168218
se2776229001213991
u28912290012155
pacientů29702290012156106152176227284317373
s33672290012140
chronickou34302290012145101135190247271317364419475
obstrukční39292290012155113154189222278326371427451
plicní4404229001215782106152208232
nemocí46602290012155107191248294318
(CHOPN)5002229001212885150221276341369
vyskytuje53952290012148100425243001213987138175231255306
často751243001214494134168223
a9942430012148
může10612430012183139182233
významně1314243001214899145201250333389440
zhoršovat1774243001214399155188229285333382415
denní22092430012156107164220244
fungování,2472243001212986142199254302351407431453
kvalitu2945243001214698147171195229285
života3249243001214367116171204254
i35232430012123
zvládání3566243001214294119167225274329353
základního3939243001214393141166215273329352410466
respiračního4425243001213283123180205238287332388412470526
onemocnění.49702430012155112163247303349405456512536558
Její425257001213789114138
vznik591257001214894150174222
obvykle8412570012155113162213262288339
nelze12082570012156107132176227
vysvětlit14632570012148100140190240275299323357
jedinou1848257001212476134158214270327
příčinou.2203257001215791115160184240297353375
Uplatňují26062570012165122147196230286341366390
se3024257001214091
noční31432570012156112158215239
dušnost,34102570012156112152208264305339362
kašel3800257001214797137188213
a40412570012148
produkce4118257001215690146204260308352402
sputa,4548257001214097154188238260
změny48362570012143127179235282
ventilace5146257001214898155188212236285331381
během4252710012157109166217302
spánku,757271001214097147204252308330
hypoxemie11172710012156102161218265315399424475
nebo16222710012156107165222
hyperkapnie,18752710012155102161213247295345403460484535556
overlap24622710012155103153187212261319
syndrom2811271001214089146204238293378
CHOPN32192710012158124194249315
a35642710012148
obstrukční36432710012155113153188222278326371427451
spánkové4124271001214098147204252306355405
apnoe,45592710012148106163219271292
bolest,48812710012157114139191231266289
refluxní5200271001213383114142198246303327
choroba,4252850012145101157191246305354376
nykturie,8212850012156102151188244277302353374
srdeční1215285001214073130181228284308
selhání,1543285001214091116172221278302323
úzkost1887285001215599147201242277
a21842850012148
deprese,22522850012156108166200250291342363
užívané2635285001215599124173223279330
léky2985285001212475124175
i31802850012123
behaviorální32242850012156108165214262287343376426450507531
faktory.3775285001212979127163219252304321
Diagnostika4116285001216792140197254310350385409457507
je4643285001212476
především4739285001215790141199251299340364448
klinická520728500121477397153177223270321
a4252990012148
musí5042990012183139180204
odlišit7382990012155114138162203227261
subjektivní1029299001214096154179230279316340389447471
kvalitu15302990012147100150174198232289
spánku1849299001214097147204252308
od21882990012155113
spánkové2332299001213997147204252307355405
efektivity,2768299001215081132181218242291316351402419
která3217299001214784135169219
je3466299001212476
vypočítaným35722990012149101159217263287321372428475560
parametrem.41632990012157107140190275326361395446531553
Součástí47462990012150106163209259299334358
vyšetření51352990012148100140192227260311368392
má4253130012183132
být5793130012157105142
spánková743313001214097147203251306354403
anamnéza,11683130012148105154238294346390441463
spánkový1653313001213997147203251305354405
deník,20803130012157108165189238263
zhodnocení2365313001214299155213270326372422479503
závažnosti2890313001214394141191235291348388423447
insomnie3359313001212379119175260316341392
a37733130012148
cílený384331300121456995146203250
screening4115313001213985119169221278302358416
dalších45533130012156105129169193239295
poruch48703130012157114148204250306
spánku.5198313001214097147203251307329
Léčbou425327001214798145202259315
první760327001215791143200225
volby10053270012148103128185233
je1258327001212476
kognitivně-behaviorální135432700121471021592162402742983474044564905496016587077547798358699199439991023
terapie2397327001213484118167225249301
nespavosti27183270012155107147205255302357397432456
(KBT-I)3195327001212882138189217244272
spolu3487327001214097154179235
s37423270012140
optimalizací38023270012155113147171255304329353397448493517
léčby4340327001212375121179226
CHOPN45863270012158123194249314
a49203270012149
souvisejících4989327001214096152201226266318343367412436482538
onemocnění.4253410012155112163248304350407458514539560
Účinek10073410012164109133189241289
samotné1317341001214090174230264320372
spánkové1710341001214097147203251305354404
hygieny21353410012156102158182234290337
a24933410012148
plicní2563341001215681105151207232
rehabilitace2816341001213383140189247271296320354404449499
na33373410012155104
insomnii3463341001212379119175260316340365
je3849341001212475
omezený39463410012155139191235286343389
nebo43573410012155107165221
nejednotný.46003410012155107131183241297354387444490508
Farmakoterapie5129341001214994127212261309364425355001213383116166223247298
má7433550012183132
být8943550012157104141
individuální,1055355001212379136160209233291346395419474498520
časově1594355001214594134190238287
ohraničená19013550012155111144193249273318368424473
a23933550012148
pravidelně2461355001215790139187211268319344400451
přehodnocovaná.2931355001215791141197253311367422469523571620676724746
Zvláštní36973550012155101126175214249305329
opatrnost40453550012155113162195228285341380415
vyžadují4480355001214899145195252307332356
benzodiazepiny48553550012157109165209264322346394438489547571627673
a4253690012148
Z-hypnotika,497369001215681139185244300357390414462512534
zejména1055369001214394119203255312361
při1440369001215790115
hyperkapnii,15793690012156102161213247295345403459484508529
neléčené21323690012156107132184230280337388
spánkové2545369001213997146203250305353403
apnoi,29733690012148105162218243264
současném3261369001214096152198248288344396480
užívání3765369001215599124173222279303
opioidů40923690012155113138194218276331
a44473690012149
u45203690012155
křehkých4599369001214782133190237289334390
seniorů.5013369001213991148172228262318339
Antagonisté53773690012161117425383001213383140196253277317352402
orexinových847383001215589140188213269325373425470526
receptorů1393383001213384131181239273328362418
mají18313830012184133158182
u20333830012155
vybraných21083830012148100159193242298345390446
pacientů25743830012157107152176228284318373
příznivá2968383001215790115159215239289338
krátkodobá3326383001214782132165213268326382440490
respirační3836383001213384124182206240289335391415
data,42713830012157106139189211
avšak4502383001214996136186234
zkušenosti4756383001214391147188239296352392427451
u52273830012155
těžké5303383001213383127175225
CHOPN4253970012158123194248314
zůstávají762397001214399139174224271321345370
omezené.11553970012155139191235286343394415
Klíčová425414001235885110154210259309
slova:752414001234167123172223246
insomnie,1015414001212378117171254309332382401
chronická1434414001214599131185241263308354403
obstrukční18544140012155111150184216271317360415438
plicní2309414001215781103148203225
nemoc,25524140012155105188243288309
kognitivně-behaviorální28784140012147100157211234267290338393443476534584639687733757811844892915970992
terapie3888414001213382114162218242292
nespavosti,41974140012155105144200249295348387421443464
hypnotika,46784140012155100158213268300323369418438
spánková5134414001213995144198245298345393
efektivita,425428001215080130177213236285308342390411
obstrukční8584280012154112151185217273319363418441
spánková1320428001214096145200247301348397
apnoe.17384280012148105160215266286
Insomnia4254530015035103159226326395429494
in9574530015033101
patients10974530015067132179214277345393449
with15844530015091125172241
chronic18644530015052120170237305339393
obstructive22954530015066135190236286354407455490557618
pulmonary29524530015067135170270337406470519590
disease:35814530015067101157220284340403439
pathophysiology,40584530015067132179248315384452520574608675709777845914945
diagnosis4254670015067102166235303371426460515
and9794670015063131200
treatment1218467001504696159224271372435504551
Insomnia425487001212479118174257313336384
is837487001212362
an9284870012148103
independent1059487001212479136186243294350407457513545
sleep-wake1632487001214063113165222255329378425474
disorder2134487001215679119174207263313346
that2508487001213389137169
is2705487001212463
common2796487001214599182266321377
in3201487001212378
patients33084870012157105138161211267299340
with3676487001217497131186
chronic38904870012145100132187243266310
obstructive42294870012155112151185218273318353376425474
pulmonary47314870012157113136219274330378410461
disease5220487001215680119169217257307
(COPD)425501001212884150204269295
and7395010012148103160
may9175010012183132177
substantially1113501001213994150190223272328360383431454477525
impair16565010012124107163212235268
daytime19425010012156105150186210293343
functioning,2304501001212985140185220243298354377432488509
quality28315010012157112160183206239289
of3138501001215584
life,324150100121234676126146
and34055010012148104160
coping3584501001214598155179234290
with3893501001217397130185
the4097501001213388138
underlying42545010012155110167217250274321345400456
respiratory4729501001213282122178202234283315369402453
disease.5200501001215680119169217256307327
Its42551500121245696
origin539515001215587110166188243
is799515001212462
usually879515001215593147195218241288
multifactorial.11845150012183137160193215244293337372426458481529552572
Contributing17745150012157110166197230253309364396419474529
factors2321515001212977121156210242282
include2621515001212378122145199255305
nocturnal29435150012156110155190244277332379402
dyspnoea,33635150012156103142198253308358406426
cough3807515001214498152208263
and40875150012148103159
sputum,4263515001213995150183237320340
sleep-related4621515001213962112162219252285335358406438487543
changes5182515001214499146201257306345
in425529001212377
ventilation,519529001214896151183205228275307329383438458
hypoxaemia9945290012155100156211256303353435458505
or1516529001215486
hypercapnia,16195290012155100157207239282330386441463510531
COPD-obstructive21675290012157122175239272329385423457488543587622644691740
sleep2924529001213962111161217
apnoea31585290012148104159213263310
overlap,34855290012154101149181204251307326
pain,38285290012156104127181201
gastro-oesophageal40465290012155103141174206260292349399438492548603650705755802825
reflux,4888529001213281110136190236257
nocturia,51635290012154109153188242274297344364
heart4255430012155105152184219
failure,661543001212977100123177209258277
anxiety9555430012148103149172221254303
and12765430012147102158
depression,14515430012156105161194243282320342397452472
medication19405430012183133189212256304336358412467
effects,2424543001215079111161206240280301
and27425430012148102158
perpetuating29175430012157107139196246279333380412435489544
behavioural34785430012157107162209255278333387419467490
patterns.39855430012156104136171219252307345366
Diagnosis4368543001216689136191246300339361400
is4785543001212361
primarily4864543001215688111193241273296318365
clinical524654300121456790144167211259282
and4255570012148103160
should612557001213994150205228285
distinguish923557001215780119153176231287342365404459
subjective1409557001214094151174225270306329377426
sleep1862557001213963113164221
quality21095570012157112160183206239289
from2424557001213063118201
sleep2652557001213963113164221
efficiency,2900557001215079112138183206256312357406422
which33495570012174129152197252
is3628557001212362
a37175570012148
calculated3791557001214594117162217241288321370428
parameter.42455570012157106138187270320354403436452
Assessment47245570012161102141191231270353404459492
should5242557001214095150205229285
include425571001212378122145199255305
a7485710012147
structured813571001213973105160204239293325375431
sleep1262571001213962112162219
history,1498571001215578117150204236286302
sleep1817571001213962112163219
diary,2053571001215779127159209224
an22955710012148102
insomnia2415571001212378116171254308331378
severity2811571001213989136185217240273322
measure,31515710012183133180219273305354374
and35425710012148103159
targeted3718571001213381113168218251300357
screening4092571001213984116165216271294348404
for4513571001212984116
other4647571001215486141191223
sleep4888571001213962112162219
disorders.5124571001215679118172205260310343382403
Cognitive4255850012158111168223246279302350399
behavioural8425850012157107163211257281336391423472495
therapy1355585001213388138171219276322
for1695585001212984116
insomnia1829585001212378117172256311334382
(CBT-I),2228585001212984137187214239267285
together2531585001213387143193227282332365
with2914585001217397129184
optimisation31165850012155112145168251274313362394417472527
of3661585001215584
COPD37635850012158123177242
and40235850012148103159
comorbid4200585001214598182237270326350406
conditions,4624585001214598154210233266289344400439460
is5101585001212463
the5182585001213387138
firstline533858500121295587127161425599001212447102152
treatment.597599001213365115163196279330385418439
Sleep1055599001215073123174231
hygiene13065990012156101156179230285336
alone1661599001214972127183233
and19145990012148103160
pulmonary20945990012156112135218273329377410460
rehabilitation2574599001213282138186243266290313346395427450505561
have31545990012156104150200
limited3373599001212447130153186235293
or3685599001215588
inconsistent3793599001212378123177233272295334368417473505
effects4317599001215180113163209244285
on46215990012155111
insomnia.4752599001212378117172256311334382404
Pharmacotherapy51755990012153108156188272320425613001214599131186237270318375421
should868613001214095150205229285
be11756130012157108
individualised,1305613001212379135158207231287342390413436475526583604
time-limited,1931613001213356139190223248271354377410459517538
and24916130012148103160
regularly2673613001213282139194217265298321369
reassessed.3064613001213282130169209259298338388445466
Benzodiazepines35526130012154105161204258316339387430480537561616667706
and42806130012148103160
Z-drugs4462613001215579138171226282321
require4805613001213383140195218250300
particular51276130012157106138174197242297320368401
caution425627001214594148181204259315
in760627001212379
hypercapnia,8596270012155101158209242286335392448471519540
untreated14196270012155110142175225273305355412
sleep1851627001213963113164221
apnoea,20926270012148105161216267315336
concomitant2448627001214598154199253336360393442497529
opioid29976270012155112136191214271
use,3288627001215594145165
and34736270012148103160
frail3653627001212962111134157
older3830627001215579136186219
adults.40696270012148105159183216256278
Orexin43676270012169102152199223278
receptor4665627001213383128177234267321354
antagonists50396270012149104136185241296352375414448488
have4256410012155104150199
reassuring645641001213383131170209264296320375431
short-term1097641001214095150183219247280330362446
respiratory1564641001213383122179202235283316370403453
data20386410012157105137186
in2245641001212479
selected2345641001214090114164210245295352
COPD27186410012158124178243
populations,29826410012157113170225249297329352407463502523
but35266410012157113146
evidence3693641001215098122178228284329378
in4092641001212479
severe4192641001214090138187220270
disease4483641001215679118169217256307
remains4811641001213282166214237292331
limited.5163641001212447130153186236293314
Key4256580012358108158
words:6056580012375131167225267290
insomnia,918658001212379118173256312335383404
chronic13456580012145100132187242265310
obstructive16786580012155112152185218273318354377425474
pulmonary21756580012157112136219274330378410461
disease,2659658001215679118169217256306326
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