The Role of Lung Function in Adverse Health Outcomes Related to (original) (raw)
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Obstructive Airway Disease and Obstructive Sleep Apnea: Effect of Pulmonary Function
Lung, 2010
This study sought to determine whether reduced pulmonary function in obstructive airway disease (OAD) is an independent risk factor for obstructive sleep apnea (OSA). This was a prospective observational study conducted at an outpatient pulmonary clinic. Adults with a known diagnosis of COPD/asthma were enrolled as OAD group. Family members without a history of COPD/ asthma who accompanied these patients to the clinic were enrolled as a control group. The Berlin Questionnaire (BQ) was used to assess OSA risk in the OAD group and controls. Forced expiratory volume in 1 second (FEV 1 % predicted) was determined from spirometry. The subjects at high risk for OSA were referred for a full overnight polysomnogram (PSG). The prevalence of patients with a high risk of OSA was 55.2% in the OAD group, which was higher than in the controls (7.5%, p < 0.0001). OAD subjects had a higher body mass index (BMI) and larger neck circumference than controls (p < 0.01). There was no difference in FEV 1 % predicted between the OAD patients at high risk and low risk of OSA. On receiver operator curve (ROC) analysis, FEV 1 % predicted was not a significant predictor of high OSA risk. Using logistic regression, FEV 1 % predicted had no association with OSA risk. There was no correlation between FEV 1 % predicted and total apnea-hypopnea index (AHI), oxygen desaturation index, % time spent below oxygen saturation 90%, and mean oxygen saturation on multiple regression analysis. OSA appears to be
Egyptian Journal of Chest Diseases and Tuberculosis, 2013
COPD and the OSAHS are both common diseases affecting respectively 10% and 5% of the adult population over 40 years of age. Their coexistence, which is denominated as «overlap syndrome», can occur in about 0.5% of this population. Aim and materials: To assess the existence of a prevalence of OSAHS in patients with COPD through a prospective analysis: 70 had a confirmed isolated OSAHS (group A) and 11 had an OS (group B), all were compiled from January 2007 to June 2012. Results: The prevalence of OS in our study was 13.6%, OS patients were older than the isolated OSAHS patients (p < 0.05) with a male predominance in the Overlap arm (p < 0.05), and BMI was similar between the 2 groups (p = 0.22). Tobacco is retained as a risk factor and 81.8% of patients with Overlap were smoking (p < 0.05). Clinical signs most reported are nocturnal snoring and daytime sleepiness. The Epworth Sleepiness Scale was higher than 10 in the 2 groups (p < 0.05). The Berlin questionnaire realized in 30 subjects in group A, was positive (40% of cases) and was positive in 63.6% of 7 subjects in group B. Spirometry showed that vital capacity, FEV1 and FEV1/CV were significantly decreased in the Overlap group (p < 0.001). The recording shows a sleep apnea-hypopnea index (AHI) similar in the two groups (p < 0.05). Conclusion: There was no correlation between COPD and OSAHS. The latter is a risk factor for the first.
The clinical respiratory journal, 2016
The co-existence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is a common phenomenon referred to as overlap syndrome (OS). In the present study, we evaluated the prevalence of OS in mild hypoxemic COPD patients without OSA symptoms and compared characteristics of OS and COPD patients. Forty five COPD patients (mean FEV1 1671.3±532.0 ml) with mild hypoxemia presenting no sleep apnea symptoms (96% men, mean age 67.7±8.5 years) were involved in this study. Clinical characteristics were recorded, biochemical analysis and polygraphy were performed. Twenty-six patients with a RDI of ≥15 events/h were defined as OS (58%). When OS (n=26) and COPD without OSA (n=19) groups were compared, BMI (29.6±6.6 vs. 25.6±4.9kg/m(2) ; p=0.03), TNF-α level (24.8±8.1 vs. 3.6±0.8 ng/ml; p=0.03) and sleep time with SpO2 <90% (23.9±29.4 vs. 9.7±21.9%; p=0.02) were significantly increased in OS. Univariate analysis showed a correlation between RDI and BMI (p<0.01), E...
Revista de Chimie
Association between chronic obstructive pulmonary disease (COPD) and sleep apnea SA (overlap syndrome - OS) includes serious clinical manifestations and high mortality due to early respiratory failure, cardiovascular and metabolic complications from both diseases. 90 COPD patients (85.5% males) were strongly suspected to have concomitant SA after clinical examination and sleep questionnaires. We performed a cardio-ventilatory poligraphy during sleep. 82 patients (91.1%) from our OS group had obstructive sleep apnea (OSA), 8 patients (8.9%) mixed apnea and 20% had also OHS. 17 (18.8%) of OS were overweight and 66 (73.3%) obese. A third of them were in a very active group of age: 49 patients (54.4%) under 60 year-old and 11 patients (12.2%) between 61-65 year/old. We noted severe complication/comorbidities in our OS group: 63.3% hypertension, 43.3% core pulmonale, 31.1% arrhythmia, 32.2% cardiac failure, 38.8% dyslipidemia, 31.1% diabetes. The second night investigation permitted titr...
The intersection of obstructive lung disease and sleep apnea
Cleveland Clinic Journal of Medicine, 2016
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have synergistic detrimental effects. Their comorbid association leads to compromised gas exchange (hypoxia and hypercapnia) and higher rates of morbidity and death. As our understanding of the pathophysiologic processes of sleep evolves, the relationship between OSA and obstructive lung diseases such as COPD ("overlap syndrome") or asthma ("alternative overlap syndrome") has become more apparent. The pathophysiology of the combined conditions and optimal management are still being defi ned, but the effect on quality of life and morbidity underscore the importance of proper diagnosis and appropriately tailored management in these patients. KEY POINTS Obstructive lung diseases and OSA are both common and may exacerbate each other. When assessing a patient with COPD, it may be prudent to think about whether the patient also has OSA, and vice versa. Oxygen therapy lowers the risk of death in patients with COPD but may worsen hypercapnia and apneic episodes in those with OSA. Continuous positive airway pressure is the fi rst line of therapy for overlap syndrome. Daytime hypercapnia and nocturnal hypoxemia despite supplemental oxygen therapy are indications for nocturnal bilevel positive airway pressure therapy, regardless of the presence of OSA.
Medicina
Background and objectives: Obstructive sleep apnea-hypopnea syndrome (OSAHS) and chronic obstructive pulmonary disease (COPD) are independently linked to an increase in cardiovascular disease (CVD). Only a few studies have been published linking the association between overlap syndrome and congestive heart failure (CHF). This review highlights the interplay between overlap syndrome (OSAHS-COPD) and CHF. Materials and methods: We thoroughly reviewed published literature from 2005 to 2022 in PubMed, Google Scholar, and Cochrane databases to explore the link between overlap syndrome and cardiovascular outcomes, specifically congestive heart failure. Results: Research indicates that individuals with overlap syndrome are more likely to develop congestive heart failure than those with COPD or OSA alone. Congestive heart failure is a common comorbidity of overlap syndrome, and it has a two-way connection with sleep-related breathing disorders, which tend to occur together more frequently t...
Journal of Health Sciences and Medicine, 2022
Aim: Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) have common pathophysiological mechanisms affecting the prognosis of each other. This study aims to investigate the relationship between the presence of OSA risk and the severity of COPD and to determine the possible clinical features for OSA risk for COPD patients. Material and Method: The patients (n=181) who applied to the outpatient clinics of pulmonology between September-November 2019 with the diagnosis of COPD, were analyzed cross-sectionally. Demographic features, anthropometric measurements, comorbidities, smoking status, and severity of dyspnea, respiratory functions, and exacerbation frequency in the last year were evaluated. All patients were questioned with the Epworth sleepiness scale (ESS) for detecting excessive daytime sleepiness (EDS), and the STOP-Bang for determining the risk of OSA. Results: The rate of diabetes, waist and hip circumference measurements, median ESS score, and EDS ratio were found to be higher in patients with moderate/high OSA risk when compared to patients with low OSA risk. In the multivariate regression model; lower oxygen saturation (OR: 0.83; p=0.007) and higher ESS score (OR=1.28; p<0.001) were determined as independent risk factors affecting the OSA risk to be moderate/high. Conclusion: Low oxygen saturation, accompanying diabetes, high ESS score and, high waist-hip circumference stand out as useful factors in determining OSA risk in the COPD population. However, OSA risk was found to be the same among all COPD stages. We suggest that all COPD patients should be questioned for OSA risk regardless of the stage.