Fixed-pressure nCPAP in patients with obstructive sleep apnea (OSA) syndrome and chronic obstructive pulmonary disease (COPD): a 24-month follow-up study

Abstract

In conclusion, in our patients with both severe OSA and mild-to-moderate COPD, arterial blood gasses and MPAP improved and stabilized after 3 months of nCPAP therapy, with the greatest improvements being in ESS score, T (90), and maximal inspiratory force from 3 up to 12 months; these parameters remained stable over the following 12 months. Finally, our data support early treatment with nCPAP in such patients.

Obstructive sleep apnea exacerbates airway inflammation in patients with chronic obstructive pulmonary disease

“…Moreover, TNFα can activate transcription factor nuclear factor-κ-B, which is up-regulated in macrophages and epithelial cells [37]. that the overlap syndrome is associated with an increased risk of death and hospitalization because of exacerbation, and that CPAP treatment could improve survival, decrease hospitalizations [6,[40][41][42], and improve walking capacity [43]. Several potential mechanisms that may account for the observed higher mortality in overlap patients have been reviewed previously [44].…”

Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure

“…Although TFPI serum levels have been reported to be increased in patients with OSAS [73], TFPI elevation does not correlate with the severity of OSAS and no definitive evidence on the effect of CPAP treatment on TFPI has been produced [34]. The chronic intermittent hypoxia induces the production of TFPI via the activation of transcription factor early growth factor 1 [74][75][76], but available data do not support TFPI as a pathophysiological mechanism linking OSAS and cardiovascular disorder. Recently, a role for TFPI in signal transduction, tumour metastasis, growth, wound-healing and angiogenesis has been reported [77].…”

COPD+OSA: can two bad things be good for you?

“…The question now is to demonstrate whether non-invasive positive-pressure ventilation, when compared with CPAP, has a positive impact on clinical outcomes, particularly in patients with overlap syndrome without hypercapnia 5 19. COPD exacerbations are common in patients with overlap syndrome 6.…”