OSA–COPD overlap syndrome

Jun. 9, 2016
Osa–Copd Overlap Syndrome - Cansleep Services Inc

Did you know: At least 1 in 10 people with obstructive sleep apnea (OSA) also have COPD (chronic obstructive pulmonary diseases) also known as overlap syndrome. The focus of this blog is on overlap syndrome.

+750,000 Canadians have COPD which is a progressive lung diseases that make it difficult to breathe such as emphysema, chronic bronchitis and non-reversible asthma. Unfortunately at least 7 of 10 people with COPD don’t know they have it. COPD symptoms (e.g. shortness of breath, wheezing, and chronic coughing) often don’t appear until your lungs are significantly damaged. Both OSA and COPD are strongly linked to smoking (use and second hand) and also worsens when gastrointestinal reflux disease (GERD) is present.

Sleep is the period of greatest physiologic disturbance in COPD and the time of greatest danger to these individuals. Sleep aggravates their abnormalities of gas exchange and could cause secondary pulmonary hypertension and cardiac arrhythmias. A COPD patient has a 10% chance of developing sleep apnea and vice versa. On their own, both chronic conditions lower patients’ quality of life and are potentially fatal. But combined, they can be even worse than the sum of their symptoms, so treating both is critical.

Due to the breathing difficulties those with COPD commonly have low oxygen level at all hours of the day, those who have both COPD and OSA are at greater risk of prolonged oxygen desaturation at night than those with OSA but without COPD. Therefore, patients with overlap syndrome are particularly prone to the complications of chronic hypoxaemia (low oxygen levels in your blood), such as cor pulmonale and polycythaemia and also have higher risk of hospitalizations from acute exacerbations.

Using CPAP significantly reduces rates of intubation (inserting a tube into someone’s throat to assist breathing in COPD) and acute respiratory failure. CPAP also can increase inspiratory capacity (ability to inhale) in patients with stable COPD, especially in those with emphysema.

Some COPD patients are on oxygen therapy and as well as CPAP therapy. If this is you contact your clinician at CanSleep to find out how to combine both therapies at night to get the optimal benefits.

By Bahareh Ezzati (BSc, CPhT, RRT)