Obstructive Airway Disease and Obstructive Sleep Apnea: Effect of Pulmonary Function

Abstract

This study sought to determine whether reduced pulmonary function in obstructive airway disease (OAD) is an independent risk factor for obstructive sleep apnea (OSA). This was a prospective observational study conducted at an outpatient pulmonary clinic. Adults with a known diagnosis of COPD/asthma were enrolled as OAD group. Family members without a history of COPD/asthma who accompanied these patients to the clinic were enrolled as a control group. The Berlin Questionnaire (BQ) was used to assess OSA risk in the OAD group and controls. Forced expiratory volume in 1 second (FEV1 % predicted) was determined from spirometry. The subjects at high risk for OSA were referred for a full overnight polysomnogram (PSG). The prevalence of patients with a high risk of OSA was 55.2% in the OAD group, which was higher than in the controls (7.5%, p < 0.0001). OAD subjects had a higher body mass index (BMI) and larger neck circumference than controls (p < 0.01). There was no difference in FEV1 % predicted between the OAD patients at high risk and low risk of OSA. On receiver operator curve (ROC) analysis, FEV1 % predicted was not a significant predictor of high OSA risk. Using logistic regression, FEV1 % predicted had no association with OSA risk. There was no correlation between FEV1 % predicted and total apnea-hypopnea index (AHI), oxygen desaturation index, % time spent below oxygen saturation 90%, and mean oxygen saturation on multiple regression analysis. OSA appears to be common in patients with COPD or asthma in an urban outpatient pulmonary clinic. However, the high prevalence of OSA in OAD patients appears to be due to obesity, and reduced pulmonary function is not an independent risk factor for OSA.

Inspiratory pre‐motor potentials during quiet breathing in ageing and chronic obstructive pulmonary disease

“…However, because those with a BP were, on average, 13 years older than those without a BP, the higher incidence of BPs in the severe OSA group may have been confounded by age. Our data suggest that age is a significant contributor to the presence of a BP in quiet breathing and, although we do not have polysomnography tests for OSA in our participants, our OSA risk data, which is a good predictor of OSA (Sharma et al ., ), suggests that, similar to COPD, OSA did not play a part in BP incidence.…”

High Prevalence of Obstructive Sleep Apnea in Patients with Moderate to Severe COPD

“…However, the authors studied a community sample of patients with mild subclinical disease, and thus the findings may not generalize to clinical cohorts. On the other hand, Sharma and coworkers found a high risk of OSA in patients with COPD, but the authors failed to use gold standard polysomnography, and thus the results may be biased by misclassification (45).…”

Evaluation of Right Ventricular Remodeling Using Cardiac Magnetic Resonance Imaging in Co-Existent Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea

“…The mean duration of the OSA symptoms before the diagnosis in these patients was made at 20 months. We have previously shown that OSA is an under-diagnosed co-morbidity in COPD patients (27). This is important, because CPAP treatment has been shown to reverse pulmonary hypertension in OSA (8), and even reduce COPD-exacerbation related hospitalizations and mortality in patients with the overlap syndrome (4).…”