OSA and COPD: The Overlap Syndrome

[LarryD]

I found an article at http://www.rcjournal.com/contents/10.10/10.10.1333.pdf that gives a lot of information on this subject. It still doesn't answer all my questions but it is the best info I've found so far.

If there is anyone else out there with COPD you might find this informative. If you know of anything more recent, please post it.

[ameriken]

Thanks for raising this issue because I was beginning to think there was a correlation. I read the article and posted this in the other thread that you posted the link.

If you can get past the terminology it's quite interesting. Of interest was this (I noted the oxygen nadir in my own sleep study at 83%):

The most significant sleep abnormality associated with
COPD is nocturnal oxygen desaturation.38,39 Even without
any upper-airway contribution, various studies have reported
that 27–70% of patients with COPD with awake
oxygen saturation of 90–95% can experience substantial
desaturation at night, particularly during REM sleep
(Fig. 1).40-42 Nocturnal oxygen desaturation can be defined
or measured in terms of oxygen nadir or time below some
oxygen-saturation limit, such as 88% or 90%.

This:

It is also still worth emphasizing that, although there
may be no increased association between relatively mild
COPD and OSA, because of the rising prevalence of these
diseases, a patient with one of the disorders will often have
the other disease.

And about our mortality with the overlap syndrome:

Ominously for patients with the overlap syndrome , several pulmonary
parameters have been shown to increase mortality in patients
with OSA.

And finally:

Recent work by Mermigkis showed that, in addition to
increased morbidity and mortality, patients with the overlap
syndrome also have significantly worse quality of life (measured with the St George’s Respiratory Questionnaire),
when compared to COPD-only controls.71 Of note, the
overlap syndrome patients in their study were COPD patients
with habitual snoring but without reported excessive
daytime sleepiness or elevated Epworth sleepiness score,
which highlights the difficulties with clinical diagnosis
and screening.

I've wondered quite a bit about this relationship between the OSA and COPD since I was diagnosed with both in a time frame fairly close to each other. I've been feeling tired even with an AHI of 2 or 3. But everytime I ask a doctor about the relationship, I get an answer that the two are unrelated and have no effect on each other. If I can find out more about this overlap syndrome, I'll be posting it.

[deltadave]

Thanks for raising this issue because I was beginning to think there was a correlation.

The relationship is not correlative, it's coincidental.

Get a whole pile of OSA guys, and a whole pile of COPD guys (and guyettes) and some of them will "overlap".

[Mimmie]

I have asthma, COPD and, ofcourse, our favorite friend that we all have to talk about all of the time. I have found that my lungs are much better since the cpap came into my life, or rather, I sleep much better and it's easier for me to breathe at night. My asthma is under control but I have lots of allergies that set it off and that makes the COPD ready to party and then that leads to pneumonia every time I turn around. The cpap helps that too. "Snuffle" is my best friend.

[ameriken]

I found this by Resmed, obviously for technicians, but quite considerably more pallatable than some of the more technical reports and studies. Seems to be very little, if any info for the patient/lay person.

http://www.tjc.edu/RespiratoryCare/PDF/ ... __COPD.pdf

[ameriken]

Here's a powerpoint I found, given at an awake meeting in 2009. Pretty good info on the subject but it's really been tough finding anything from a laypersons POV.

http://www.google.com/url?sa=t&rct=j&q= ... P1bw1t8TOA

There's a lot out there for the medical profession but it just seems like finding a doctor who knows anything about sleep apnea is tough enough, much less finding one who knows about the overlap. The forum has a lot of people who are using cpap who still feel tired, and I'm wondering if this overlap is a cause in many of them.

An RT from the DME will be out this week to do a 6 month check on my machine and restock of supplies/equipment. I intend to ask about this and see if he/she has any helpful knowledge about this as well as any practical and usable insights and if there are any changes I can make with the ASV that might help.

I think my doc is on the right track with the oximeter which I'll hopefully have this week. Anyhow, the search continues.

[dupko]

Thanks for raising this issue because I was beginning to think there was a correlation.

The relationship is not correlative, it's coincidental.

Get a whole pile of OSA guys, and a whole pile of COPD guys (and guyettes) and some of them will "overlap".

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