Cardiovascular outcomes in patients with COPD-OSA overlap syndrome: A systematic review and meta-analysis

Aj, Shah; Quek, Eleanor; Alqahtani, Jaber S; Hurst, John R.; Mandal, Swapna

doi:10.1016/j.smrv.2022.101627

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…It has been shown that the prevalence of sleep disturbance is higher in individuals with chronic respiratory disease, such as chronic obstructive pulmonary disease (COPD) (47) and asthma (48), which was probably because sleep disturbance was a premonitory or accompanying symptom of respiratory disease. Another possible explanation would be that sleep disturbances usually overlapped with some respiratory diseases (49)(50)(51), which was associated with a worse prognosis (52)(53)(54). Our results indicated that effective prevention and treatment of respiratory diseases may be worth advocating for in individuals with sleep disturbances.…”

Section: Discussionmentioning

confidence: 67%

Self-Reported Sleep Disturbance is an Independent Predictor of All-Cause Mortality and Respiratory Disease Mortality in US Adults: A Population-Based Prospective Cohort Study

Hou

Hu²,

Wang³

et al. 2023

Int J Public Health

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Objective: Self-reported sleep disturbance is common but its association with mortality has rarely been investigated.Methods: This prospective cohort analysis included 41,257 participants enrolled in the National Health and Nutrition Examination Survey from 2005 to 2018. Self-reported sleep disturbance in the present study refers to the patients who have ever consulted doctors or other professionals for trouble sleeping. Univariate and multivariate survey-weighted Cox proportional hazards models were used to evaluate the association of self-reported sleep disturbance with all-cause and disease-specific mortality.Results: Approximately 27.0% of US adults were estimated to have self-reported sleep disturbance. After adjusting for all sociodemographic variables, health behavioral factors, and common comorbidities, participants with self-reported sleep disturbance tend to have higher all-cause mortality risk with a hazard ratio (HR) of 1.17 (95% CI, 1.04–1.32) and chronic lower respiratory disease mortality risk (HR, 1.88; 95% CI, 1.26–2.80), but not cardiovascular disease mortality risk (HR, 1.19; 95% CI, 0.96–1.46) and cancer mortality risk (HR, 1.10; 95% CI, 0.90–1.35).Conclusion: Self-reported sleep disturbance could be associated with higher mortality in adults, and may need to be paid more attention in public health management.

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Section: Discussionmentioning

confidence: 67%

Self-Reported Sleep Disturbance is an Independent Predictor of All-Cause Mortality and Respiratory Disease Mortality in US Adults: A Population-Based Prospective Cohort Study

Hou

Hu²,

Wang³

et al. 2023

Int J Public Health

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“…Therefore, it can be expected that CVDs are more prevalent in patients with OS compared with OSA or COPD alone. Indeed, OS is associated with higher prevalence of comorbidities, such as hypertension, peripheral vascular disease, diabetes mellitus and obesity, compared with COPD or OSA alone [ 1 , 6 , 11 ]. However, a recent review underlines that although patients with OS have a high prevalence of CVD there is some suggestion but no valid evidence of an increased risk compared with patients with either condition alone [ 11 ].…”

Section: Osa and Copdmentioning

confidence: 99%

“…Indeed, OS is associated with higher prevalence of comorbidities, such as hypertension, peripheral vascular disease, diabetes mellitus and obesity, compared with COPD or OSA alone [ 1 , 6 , 11 ]. However, a recent review underlines that although patients with OS have a high prevalence of CVD there is some suggestion but no valid evidence of an increased risk compared with patients with either condition alone [ 11 ]. OS patients also have a higher incidence of pulmonary hypertension and right ventricular remodelling and increased risk of arrhythmias like atrial fibrillation [ 3 ], leading to higher hospitalisation rate and worse mortality [ 10 ].…”

Section: Osa and Copdmentioning

confidence: 99%

Overlaps between obstructive sleep apnoea and other respiratory diseases, including COPD, asthma and interstitial lung disease

Bouloukaki

Fanaridis²,

Testelmans³

et al. 2022

Breathe

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In the past, there was limited research relating to the role of sleep in respiratory diseases. Physicians treating these patients tended to focus mainly on the daily disabling symptoms, overlooking the possible significant role of coexisting sleep disorders such as obstructive sleep apnoea (OSA).Nowadays, OSA has been recognised as an important, highly prevalent comorbidity for respiratory diseases such as COPD, asthma and interstitial lung diseases (ILDs). Overlap syndrome refers to the coexistence of chronic respiratory disease and OSA in the same patient. Although, in the past, overlap syndromes have been poorly studied, recent data underline that they result in increased morbidity and mortality compared with either underlying disorder alone. OSA and respiratory disease may be of different severity, and this, along with the existence of various clinical phenotypes, points to the necessity of an individualised therapeutic plan. Early recognition and OSA management could offer key benefits, such as improved sleep, quality of life and disease outcomes.Educational aimsDescribe pathophysiological aspects of OSA in chronic respiratory diseases such as COPD, asthma and ILDs.Understand the bidirectional clinical importance when OSA coexists in chronic respiratory diseases.Review current knowledge of treatment strategies towards an individualised therapeutic plan resulting in patient-centric outcomes.

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“…The OVS has been associated with cardiac arrhythmias [8], pulmonary hypertension and right heart failure [9]. OVS patients seem to show higher odds for prevalent coronary heart disease, heart failure and peripheral arteriopathy [10], and overall, this condition was associated with higher rates of cardiovascular morbidity and all-cause mortality [11,12]. However, it remains unknown if the overlap of each disorder amplifies the inflammatory responses and if the pro-inflammatory state is mainly triggered by intermittent nocturnal hypoxia or by comorbid risk factors like obesity or frequent exposure to smoking [13,14].…”

Section: Introductionmentioning

confidence: 99%

Sleep and cardiometabolic comorbidities in the obstructive sleep apnoea–COPD overlap syndrome: data from the European Sleep Apnoea Database

et al. 2023

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AimThe impact of OSA-COPD overlap syndrome (OVS) on sleep quality and cardiovascular outcomes has not been fully explored. We aimed to compare clinical and polysomnographic characteristics of OVSversusOSA patients, and to explore pathophysiological links between OVS and comorbidities.Study design and methodsThis cross-sectional analysis initially included data from 5600 patients with OSA and lung function in the European Sleep Apnoea Database (ESADA). Two subgroups of patients with OSA (n=1109) or OVS (n=509) were matched (2:1) based on sex, age, body mass index (BMI), and apnoea-hypopnea index (AHI) at baseline.ResultsAfter matching, OVS patients had more severe hypoxia, lower sleep efficiency and presented higher prevalence of arterial hypertension, ischemic heart disease and heart failure compared to OSA patients.OVS was associated with a significant decrease in sleep efficiency (β −3.0% (95%CI −4.7, −1.3) and in nocturnal mean SpO2(β −1.1% (95%CI −1.5, −0.7). Further analysis revealed that a decrease in FEV1and PaO2was related with a decrease in sleep efficiency and in mean nocturnal SpO2.A COPD diagnosis increased by 1.75 and 1.36 the odds of having heart failure (95%CI 1.15, 2.67) and systemic hypertension (95%CI 1.07, 1.73), respectively.Nocturnal hypoxia was strongly associated with comorbidities, interestingly, the mean nocturnal SpO2and T90 were associated with increase odds of systemic hypertension, diabetes, and heart failure but ODI was only related to hypertension and diabetes.ConclusionOVS patients presented with more sleep-related hypoxia, a reduced sleep quality and a higher risk for heart failure and hypertension.

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Cardiovascular outcomes in patients with COPD-OSA overlap syndrome: A systematic review and meta-analysis

Cited by 21 publications

References 31 publications

Self-Reported Sleep Disturbance is an Independent Predictor of All-Cause Mortality and Respiratory Disease Mortality in US Adults: A Population-Based Prospective Cohort Study

Self-Reported Sleep Disturbance is an Independent Predictor of All-Cause Mortality and Respiratory Disease Mortality in US Adults: A Population-Based Prospective Cohort Study

Overlaps between obstructive sleep apnoea and other respiratory diseases, including COPD, asthma and interstitial lung disease

Sleep and cardiometabolic comorbidities in the obstructive sleep apnoea–COPD overlap syndrome: data from the European Sleep Apnoea Database

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