Clinical Evaluation and Management of Overlap Syndrome (OS) and Obesity Hypoventilation Syndrome (OHS)

Abstract

Background and Aim: Sleep-disordered breathing (SDB) is an extremely common disorder with a high impact on morbidity and mortality. The purpose of this study was to compare overlap syndrome (OS) and obesity hypoventilation syndrome (OHS) and to highlight and understand the differences between them. Material and Methods: The study was conducted retrospectively on 132 subjects selected by consecutive sampling from those attending our unit for suspected SDB. After clinical evaluation as well as functional and sleep investigations, the population was divided according to diagnosis in OS and OHS; then, the clinical parameters of two groups were compared with different statistical analysis. Results: The subjects with OHS were younger and reported higher rated daytime sleepiness (p = 0.005). In addition, they presented more nocturnal respiratory events (apnea-hypopnea index (AHI) 63.61 ± 22.79 events·h−1 vs. AHIOS 42.21 ± 22.91 events·h−1, p < 0.0001) at the sleep investigation as worse gas exchange during sleep leading to a higher percentage of nocturnal hypoxemia (p < 0.0001). In contrast, subjects with OS had more an impaired respiratory function. With regard to night-time ventilatory therapy, more subjects with OS were effectively treated with continuous positive airway pressure (CPAP) (p = 0.011), while more OHS were treated with auto-adjusting PAP (APAP) (14% vs. 1%, p = 0.008). Conclusions: The present study tried to establish a framework for OS and OHS because proper management of the two disorders would reduce their burden on healthcare.

Chronic Obstructive Pulmonary Disease and Sleep Apnea Syndrome – a Multidisciplinary Problem of Clinical Medicine

“…Крім того, вона має масштабні соціальні наслідки на популяційному рівні. Тому в усьому світі медичними фахівцями вказується на гостру необхідність проведення популяційних досліджень коморбідності і особливо відзначається, що поліпатія кардинально впливає на визначення діагностично-лікувального підходу ведення хворого та його прогноз, що є надважливим [19,23,25].…”

“…• підвищення тонусу симпатичної нервової системи, • інтермітуюча гіпоксемія, • оксидативний стрес, • системне запалення, • ендотеліальна дисфункція, • метаболічні порушення, • зміни внутрішньогрудного тиску [16,17,19,23,25]. Поєднання ХОЗЛ та СОАС взаємно обтяжує перебіг цих нозологій та пов'язане з більш несприятливим прогнозом, ніж будь-яке з цих захворювань окремо [21,24].…”

Nocturnal Hypoventilation in the Patients Submitted to Thoracic Surgery

“…Beyond obesity, the other main causes of nocturnal hypoventilation include chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA), neuromuscular disorders, and severe chest wall abnormalities [ 9 , 10 ]. In COPD patients, hypoventilation during sleep is a common feature, first appearing during REM (rapid eye movement) sleep; then, in non-REM sleep, before daytime, chronic hypercapnia will develop [ 11 ].…”

“…OSA, although very common in the adult population, in majority of cases remains unrecognized and untreated [ 12 ]. In addition, OSA frequently co-occurs with obesity and, in minor degree, with COPD [ 10 ].…”