Effect of CPAP on Long-Term Mortality in Overlap Syndrome: Is Hypercapnic the Best Appropriate Determinant?

Esquinas, António M.; Marrero, Fernando León; Esteva, Javier Navarro

doi:10.1007/s00408-014-9613-6

Cited by 1 publication

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“…(10,11) Cohort studies suggest that the added risk related to OVS may be reduced by Positive Airway Pressure (PAP) treatment of OSA. (11)(12)(13) Therefore, management of OSA in COPD is recommended by the current GOLD guidelines. (14) OVS is still commonly undiagnosed as clinical features and questionnaires lack sensitivity and often overlap with symptoms of COPD alone.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of routine sleep assessment by peripheral arterial tonometry in patients with COPD

Hansson

Andersson²,

Vanfleteren³

et al. 2023

ERJ Open Res

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BackgroundCoexisting obstructive sleep apnoea (OSA) in patients with chronic obstructive pulmonary disease (COPD), defined as overlap syndrome (OVS), is prevalent and underdiagnosed. Routine assessment of OSA is not common practice in COPD care. Our study assessed the clinical impact of sleep-assessment by peripheral arterial tonometry (PAT) in COPD patients.Methods105 COPD patients (mean age 68.1±9 years, BMI 28.3±6.0 kg·m−2, 44% males, GOLD stages I to IV in 2%, 40%, 42%, and 16%, respectively) underwent assessment at an outpatient COPD-clinic including anthropometrics, arterial blood gas (ABG) and spirometry in this clinical cohort study, PAT-based sleep studies were performed. Predictors of OVS and ABG were determined. Rapid Eye Movement (REM) sleep-related OSA was analyzed in OVS.Results49 COPD patients (46%) suffered from moderate to severe OSA (OVS group, mean AHI 30.8±18 n·h−1, REM-Oxygen Desaturation Index (REM-ODI) 26.9±17 n·h−1). OVS was more prevalent in males compared to females (59% and 37%, p=0.029, respectively). Age (70.1±8versus66.3±10 years), BMI (30.0±6versus26.4±7 kg·m−2) and hypertension prevalence (71%versus45%) were elevated (all p<0.03, respectively), while deep sleep (12.7±7% and 15.4±6%, p=0.029) and mean overnight oxygenation (90.6±3% and 92.3±2%, p=0.003) were lower in OVS compared to COPD alone. REM-ODI was independently associated with daytime pCO2(β=0.022, p<0.001). REM-OSA was associated with an elevated prevalence of atrial fibrillation (25% and 3%, p=0.022).ConclusionsOVS was highly prevalent, specifically in obese males. REM-related OSA showed strong association with elevated daytime pCO2 and prevalent cardiovascular disease. PAT was feasible for sleep assessment in COPD.

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Section: Introductionmentioning

confidence: 99%

Clinical impact of routine sleep assessment by peripheral arterial tonometry in patients with COPD

Hansson

Andersson²,

Vanfleteren³

et al. 2023

ERJ Open Res

View full text Add to dashboard Cite

show abstract

Effect of CPAP on Long-Term Mortality in Overlap Syndrome: Is Hypercapnic the Best Appropriate Determinant?

Abstract: Overlap syndrome and represents a complex clinical condition in pulmonary medicine. We discuss in this letter factors related with mortality after long-term effects CPAP and key differences between hypercapnic versus hypoxemic overlap patients.

Cited by 1 publication

References 8 publications

Clinical impact of routine sleep assessment by peripheral arterial tonometry in patients with COPD

Clinical impact of routine sleep assessment by peripheral arterial tonometry in patients with COPD

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