Background: Both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSAS) are common diseases. Some recent studies suggest an increased prevalence of COPD among subjects with OSAS. Objectives: The study objective was to evaluate whether there is an epidemiological relationship between COPD and OSAS in a random population sample. Materials and Methods: The study population, 356 males (53%) and 320 females, mean age 56.6 ± 8.2 years (range 41–72), was selected from a voting list for parliamentary election in Warsaw. The investigation included lung diseases and smoking history with polysomnography and spirometry. Results: OSAS was diagnosed in 76 subjects (11.3%), 59 males (8.8%) and 17 females (2.5%), mean apnea/hypopnea index (AHI) was 25.3 ± 16.1, mean overnight SaO₂ 92.1 ± 3.3%, minimum SaO₂ 76.9 ± 9.4%, and SaO₂ <90% = 18.9 ± 23.9% of total sleep time. COPD was diagnosed in 72 subjects (10.7%), 39 males and 33 females. Severity of airflow limitation was assessed according to European Respiratory Society (ERS) guidelines: mild in 70%, moderate in 22%, and severe in 8%. In 7 subjects (9.2% of OSAS population, 1% of total population) OSAS and COPD overlapped. Polysomnographic variables were compared between overlap (overlap syndrome, OS) and OSAS subjects. In the OS mean AHI was 19.0 versus 25.3 in OSAS (nonsignificant), mean SaO₂ 89.6 versus 92.3% in OSAS (p < 0.005), and time spent in SaO₂ <90% was 25.4 versus 18.2% in OSAS (p = 0.04). Conclusions: COPD in subjects with OSAS was as frequent as in the general population. In the OS group mean arterial blood saturation was lower and time spent in desaturation was longer than in OSAS. The presented data suggest a more severe course of sleep-disordered breathing in subjects with coexisting COPD.

Summary Obstructive sleep apnoea syndrome (OSAS) is a frequent disorder; however, the prevalence of sleep‐disordered breathing is not well known in many countries. The aim of our investigation was to assess the prevalence of sleep‐disordered breathing (SDB) in a representative sample of the population of Warsaw. We studied 676 subjects (57.1% of the randomised cohort from the Monica II study). The sample comprised 356 males (52.7%) and 320 females (47.3%), whose mean age was 56.6 ± 8.2 years (range 41–72 years). Mean number of apnoeas and hypopnoeas per hour of time in bed (AH) in males was 7 ± 9.5 and in females 3.9 ± 6.6 (P < 0.001). SDB (cut‐off point AH > 5 or >10) was identified in 188 subjects (27.8%) and 97 subjects (14.3%), respectively. SDB was established twice as frequently in males as in females (respectively 36.5 versus 18.5%; P < 0.001 for AH > 5 and 19.8 versus 8.5%; P < 0.001 for AH > 10). A diagnosis of OSAS AH > 10 and Epworth Sleepiness Score ≥11 points was established in 51 subjects (7.5%). The prevalence of OSAS was nearly four times higher in males (40 subjects, 11.2%) than in females (11 subjects, 3.4%; P < 0.001). The severity of OSAS was similar in both sexes (AH: males 32.3 ± 14.9 and females 31.4.1 ± 15.4). Older age and male sex were predictors of SDB. SDB and OSAS were independent predictors of coronary artery disease after adjusting for age, sex, body mass index, neck circumference and smoking habit.

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Introduction: Obesity and male gender are the main risk factors for the development of obstructive sleep apnoea (OSA); however, some epidemiological data has shown that neck circumference (NC) ≥ 43 cm is a better predictor of obstructive event frequency than body mass index (BMI). The aim of this study was to assess the relation between NC and BMI on OSA severity in males. Material and methods: The subjects completed a sleep questionnaire and Epworth sleepiness scale before the sleep study (full polysomnography or PolyMesam study). We studied 133 consecutive males with confirmed OSA (AHI/RDI > 10, Epworth score > 9 points). Chest X-ray, spirometry, arterial blood gases, ECG, blood morphology and biochemistry were performed during treatment trial with autoCPAP. Results: Subjects presented with obesity—BMI = 35.8 ± 6.1 kg/m2, NC = 46 ± 3.4 cm and severe disease—AHI/RDI = 45.3 ± 23.6. Mean age was 52.7 ± 11.3 years. The majority of subjects had NC ≥ 43 cm (116 pts, 87.2%—group 1), 17 pts (12.8%—group 2) had NC < 43 cm had 17 pts. Comparison of both groups showed significant differences only for BMI (gr. 1—36.8 ± 5.7, gr. 2—28.6 ± 3.7; p < 0.0001). Linear regression analysis revealed significant correlation between NC and AHI/RDI (R2 = 0.07, r = 0.26; p = 0.003); however, the correlation between BMI and AHI/RDI was stronger (R2 = 0.14, r = 0.37; p < 0.0001). In multiple linear regression analysis we found significant correlation between AHI/RDI and age (β = –0.31, p = 0.003) and BMI (β = 0.34, p = 0.02). Conclusions: The strongest correlation between AHI/RDI, younger age and BMI was found in males with OSA. Correlation between neck circumference and AHI/RDI was significant but less when compared to BMI.

SUMMAR Y The question of whether upper airway resistance syndrome (UARS) is a distinct disease or an initial feature of obstructive sleep apnoea syndrome is still a matter of debate. We evaluated a retrospective group of UARS patients to determine the evolution of UARS over time and the relationship between clinical evolution and subjectsÕ phenotype. Investigations were performed in 30 patients, in whom UARS was diagnosed between 1995 and 2000 by the use of full polysomnography (PSG) without oesophageal pressure (Pes) measurement. The time between initial and follow-up investigations was 6.6 ± 2.6 years. All subjects had full PSG with Pes measurement and completed a sleep questionnaire, including the Epworth Sleepiness Scale. In 19 subjects, PSG results were compatible with UARS. In nine subjects, obstructive sleep apnoea-hypopnoea syndrome (OSAHS) was diagnosed. In two subjects, PSG did not demonstrate breathing abnormalities. The mean ± SD apnoea-hypopnoea index in the UARS group was 1.5 ± 1.7 h )1 and 25.2 ± 19 h )1 in the OSAHS group (P < 0.01). The increase in body mass index (BMI) between initial and follow-up investigations in the UARS group was from 29.4 ± 4 to 31 ± 5.7 kg m )2 (P = 0.014) and in the OSAHS group from 30 ± 4.1 to 32.4 ± 4.7 kg m )2 (P = 0.004). Amplitude of Pes swings during respiratory events was significantly higher in OSAHS than that in UARS (P = 0.014). Our results suggest that UARS is part of a clinical continuum from habitual snoring to OSAHS. Progression from UARS to OSAHS seems to be related to an increase in the BMI.