The triad of obstructive sleep apnea syndrome, COPD, and obesity: sensitivity of sleep scales and respiratory questionnaires

Abstract

Objective:To investigate whether the presence of obstructive sleep apnea syndrome (OSAS) alters the perception of respiratory symptoms and quality of life in COPD patients, by using specific questionnaires, as well as to determine whether scales for assessing daytime sleepiness and for screening for OSAS can be used in the triad of OSAS, COPD, and obesity. Methods:We included 66 patients diagnosed with mild-to-moderate or severe COPD and presenting with a body mass index > 27 kg/m2. After polysomnography, patients completed the Epworth sleepiness scale (ESS), the Berlin questionnaire (BQ), the modified Medical Research Council (mMRC) scale, the Baseline Dyspnea Index (BDI), and the Saint George’s Respiratory Questionnaire (SGRQ). Results:Patients were first divided into two groups: COPD + OSAS (n = 46); and COPD-only (n = 20). The COPD + OSAS group was subdivided into a COPD + mild-to-moderate OSAS group (n = 32) and a COPD + severe OSAS group (n = 14), all of which were compared with the COPD-only group. There was a significant difference in mean FEV1 (L) between the COPD + OSAS groups and the COPD-only group (p = 0.073). The presence of the triad did not lead to significantly higher ESS scores, and scores > 10 had a specificity of 0.58. The BQ did not identify high risk for OSAS in the presence of the triad (specificity of 0.31). There were no significant differences in domain or total scores of the SGRQ between the COPD + OSAS groups and the COPD-only group. Conclusions:The confounding factors present in the triad of OSAS, COPD, and obesity prevented the perception of increased daytime sleepiness and high risk for OSAS. We observed no worsening of dyspnea perception or quality of life.

Prevalence of obstructive sleep apnea among patients with chronic obstructive pulmonary disease

“…The progressive impairment of pulmonary function noticed in COPD con increase the exertional dyspnea which in turn limits the activities of daily living. Also, the presence of both COPD and obesity contribute to the presence of dyspnea, fatigue, and tiredness [22]. Watson et al went in line with this finding as they detected that the annual decline in FEV 1 in obese-COPD males was higher than in those with normal BMI.…”

Sono Na Atenção Primária

“…Esses fatores tornam custo do exame elevado e inacessível a grande parte da população, especialmente na atenção primária. 16,17,18 Quando diagnosticada, o tratamento da SAOS deve ser logo instituído. Ele, quando precoce e individualizado, é capaz de melhorar a qualidade de vida do paciente, afetando positivamente seu prognóstico e, por conseguinte, economizando recursos públicos.…”

Treatment of severe stable COPD: the multidimensional approach of treatable traits

“…Nevertheless, obstructive sleep apnoea in COPD can be considered an important treatable trait, as treatment with continuous positive airway pressure has been shown to improve survival in patients with severe hypoxaemic COPD [ 112 ]. As symptoms of excessive daytime sleepiness can be confounded by COPD symptoms [ 113 , 114 ], we recommend performing a sleep study in the evaluation of a severe COPD patient, irrespective of symptoms of daytime sleepiness.…”