Lack of Benefit of Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome |
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Authors: | Email author" target="_blank">Aidan?O’BrienEmail author Kristy?Whitman |
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Institution: | (1) Division of Pulmonary and Critical Care Medicine, Providence Veterans Affairs Medical Centre, Brown Medical School, Providence, Rhode Island 02908, USA;(2) Midland Regional Hospital, Mullingar, County Westmeath, Ireland |
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Abstract: | Obstructive sleep apnea (OSA) has been shown to be an inflammatory stimulus and may potentially result in a deterioration
in the respiratory status of patients with coexistent chronic obstructive pulmonary disease (COPD) (overlap syndrome). We
hypothesized that with treatment of OSA, there would be an improvement in coexistent COPD in overlap patients. We also sought
to characterize overlap patients by comparing them with patients with either OSA or COPD alone. We performed a retrospective
study of patients who attended a university-affiliated Veterans Affairs hospital. Demographic and clinical data were obtained
from the medical charts and pharmacy records for the preceding two years and for the two years following the initiation of
continuous positive airway pressure (CPAP) therapy. Overlap patients had moderately severe sleep apnea (AHI 28.6 ± 4.2) and
moderately severe COPD (FEV1= 1.94 ± 0.10 L). The prevalence of overlap syndrome in COPD patients was 11.9%, and 41% in OSA patients. Overlap patients
who were compliant with CPAP therapy experienced a greater decrease in FEV1, percent predicted FEV1, percent decrease in FEV1, FVC, percent predicted FVC, and percent decrease in FVC when compared with noncompliant patients. A very strong correlation
was found between the average hours of CPAP use per day and the percent decrease in FEV1 (r = 0.69, p = 0.003). There was a similar strong correlation for the decrease in FEV1 and percent predicted FEV1. OSA is common in COPD patients; similarly, COPD is common in OSA patients. Treatment of OSA with CPAP therapy in patients
with overlap syndrome may not lead to an improvement in the coexistent COPD. |
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Keywords: | Obstructive sleep apnea Chronic obstructive pulmonary disease Continuous positive airway pressure Overlap syndrome |
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