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Ann Am Thorac Soc. 2015 Aug;12(8):1219-25. doi: 10.1513/AnnalsATS.201407-336OC.

High Prevalence of Obstructive Sleep Apnea in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease.

Author information

1
1 Pulmonary, Critical Care, and Sleep Division.
2
3 Physiology Division, and.
3
2 Pulmonary Division, University of Brasilia, Brasilia, Brazil.
4
4 General Internal Medicine Division, Department of Medicine, University of California, San Diego, San Diego, California; and.

Abstract

RATIONALE:

When obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) coexist in the so-called "overlap" syndrome, a high risk for mortality and morbidity has been reported. There is controversy about the prevalence of OSA in people affected by COPD.

OBJECTIVES:

The purpose of this study was to investigate objective meaures of sleep-disordered breathing in patients with moderate to severe COPD to test the hypothesis that COPD is associated with an increased prevalence of OSA.

METHODS:

Fifty-four patients (54% men) with moderate to severe COPD were enrolled prospectively (mean ± SD, FEV1 = 42.8 ± 19.8% predicted, and FEV1/FVC = 42.3 ± 13.1). Twenty patients (37%) were on supplemental oxygen at baseline. Exercise tolerance; questionnaires related to symptoms, sleep, and quality of life; and home polysomnography were obtained.

MEASUREMENTS AND MAIN RESULTS:

Forty-four patients had full polysomnography suitable for analysis. OSA (apnea-hypopnea index > 5/h) was present in 29 subjects (65.9%). Sleep efficiency was poor in 45% of subjects.

CONCLUSIONS:

OSA is highly prevalent in patients with moderate to severe COPD referred to pulmonary rehabilitation. Sleep quality is also poor among this selected group. These patients have greater-than-expected sleep-disordered breathing, which could be an important contributory factor to morbidity and mortality. Pulmonary rehabilitation programs should consider including a sleep assessment in patients with moderate to severe COPD and interventions when indicated to help reduce the impact of OSA in COPD.

KEYWORDS:

chronic obstructive pulmonary disease; obstructive sleep apnea; overlap; pulmonary rehabilitation; sleep-disordered breathing

PMID:
25871443
PMCID:
PMC5466175
DOI:
10.1513/AnnalsATS.201407-336OC
[Indexed for MEDLINE]
Free PMC Article

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