Evaluating the Relationship of Airflow Obstruction in COPD with Severity of OSA Among Patients with Overlap Syndrome

Abstract

Background

Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are common diseases affecting millions worldwide. These two diseases have a complex relationship that is not well understood. Previous small studies suggest an inverse relationship of disease severity of OSA with COPD airflow obstruction.

Objective

The aim of this study was to determine if a relationship exists between severity of airflow obstruction in COPD and severity of OSA via apnea hypopnea index obtained during an in-lab baseline polysomnogram using a large quaternary care center cohort.

Methods

From November 2015 through December 2018, 273 patients with confirmed COPD via spirometry and OSA via in-lab baseline polysomnogram were included.

Conclusion

No associations were noted between severity of airflow obstruction in COPD and disease severity of OSA. Given the heterogeneity of these diseases, further exploration of a relationship within disease subtypes is warranted.

Keywords:

• airflow obstruction
• chronic obstructive pulmonary disease
• obstructive sleep apnea

Abbreviations

COPD, chronic obstructive pulmonary disease; OSA, obstructive sleep apnea; PSG, polysomnography; FEV1/FVC, forced expiratory volume in one second/ forced vital capacity; AHI, apnea hypopnea index; GOLD, Global Initiative for Chronic Obstructive Lung Disease; FEV1, forced expiratory volume in one second; CPAP, continuous positive airway pressure; BMI, body mass index; ED, emergency department; PAP, positive airway pressure; A fib, atrial fibrillation.

Acknowledgments

We appreciate the support of the Graduate Medical Education Office of Research at the University of Nebraska College of Medicine. This study was performed at the University of Nebraska Medical Center.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Nancy H Stewart reports funding from the CHEST Foundation. Valerie G Press has consulted for Humana, Vizient, and Roundglass. She reports funding from the NIH, AHRQ, the American Medical Association, and the American Lung Association. The authors report no other conflicts of interest in this work.

Additional information

Funding

There is no funding to report.