copd and sleep apnea

familiarize yourself with diagnosis, testing, treatment options, and how to cope with the life-long effects of sleep apnea. chronic obstructive pulmonary disease (copd) and obstructive sleep apnea (osa) are two of the most common pulmonary diseases. this explains the term “overlap syndrome.” it’s a way to reference the never-ending challenges of breathing for those suffering from both copd and osa. the air-flow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases.

severity of sleep apnea is based on the length and frequency of these collapses and their related arousals. people with copd tend to have reduced levels of blood oxygen all day long, even while they are alert and breathing. when copd (or asthmatic) patients complain of sleep problems, the best way to address these is through an overnight sleep study. this reality spotlights the need for patients with breathing disorders of all kinds to receive complete and accurate diagnoses so they can receive the best possible therapy.

specifically, patients with copd and osa have a substantially greater risk of morbidity and mortality, compared to those with either copd or osa alone. these medications improve symptoms and may modestly delay disease progression; however, mortality has not been observed to improve.12 for those with daytime hypoxemia or borderline hypoxemia and evidence of right-heart dysfunction, supplemental oxygen therapy decreases mortality, and more hours of use per day have a greater benefit.13,14 osa is defined by intermittent collapse of the upper airway, which results in repetitive hypoxemia and arousal. another study in a veterans administration population found the prevalence of the overlap syndrome to be 29%, although the data were gathered in a retrospective chart study of patients who had been referred for polysomnogram and who also had an interpretable pulmonary function test.22 the seemingly very high prevalence prompted speculation that osa and copd were linked by a common mechanism or common pathophysiology. thus, when seeing a patient with either osa or copd, it is reasonable to screen for the other, based on history and review of systems. even patients with copd and daytime normoxia who have only nocturnal oxygen desaturation generally do not develop substantial pulmonary hypertension, which is supported by lack of efficacy of nocturnal supplemental oxygen in treatment trials in this patient population, as discussed below.64 mortality data for patients with the overlap syndrome have not been well studied until recently.

in the observational study by marin, death in the untreated overlap group was most commonly attributed to cardiovascular disease.70 one other intriguing possibility reported in that study is that osa may contribute to an increased incidence of copd exacerbations, which may accelerate lung-function decline and are associated with greater mortality.73,74 the most common clinical scenario is a patient known to have either osa or copd and subsequently evaluated by a primary care physician, pulmonologist, or sleep specialist. whether treatment of copd in the overlap syndrome also improves osa is not known. first, machado and colleagues reported their experience in a brazilian cohort of copd patients referred for long-term oxygen therapy (ltot).102 patients with osa symptoms were referred for polysomnography, and about 15% of ltot copd patients were confirmed to have the overlap syndrome. the morbidity and mortality of overlap syndrome is greater than that of either copd or osa alone. hypoxia is central to the pathogenesis of both osa and copd, although the continuous hypoxia of copd may be somewhat different biologically from the intermittent hypoxia of osa syndrome (osas).

the association between copd as an obstructive lung disorder and osa as a sleep breathing disorder means a person suffering from both has a compromised sleep-disordered breathing (mainly obstructive sleep apnea [osa]) and copd are among the most patients with copd and osa often report decreased sleep quality to their treating providers. the reductions in total sleep time and sleep, .

about 10% to 30% of people with copd also have sleep apnea. that combination is called “overlap syndrome” and raises your chances of having: hypercapnia (too much carbon dioxide in your blood) pulmonary hypertension (high blood pressure in your lungs’ arteries) both osa and copd are common. but when sleep apnea and copd happen at the same time, it’s known as overlap syndrome. it’s estimated that 10 to 15 percent of sleep is the period of greatest physiologic disturbance in chronic obstructive pulmonary disease (copd) and the time of greatest danger to these individuals during sleep, people with copd may experience lower levels of oxygen and high levels of carbon dioxide in the blood depending on the severity of, .

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