OSA/COPD Overlap: Convergence on a Theme?

Dorsch, Jennifer J; Wickwire, Emerson M.

doi:10.5664/jcsm.7556

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…After adjusting for covariates, we found no correlation between OSA and short-term mortality in AECOPD patients, which differs from previous studies [ 17 ]. The coexistence of OSA and COPD, known as overlap syndrome [ 26 ]. Studies have indicated that individuals with a history of exacerbations are 1.436 to 1.485 times more likely to have OSA [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the impact of OSA on short-term survival in patients with AECOPD admitted to the ICU

Liu,

Chen,

et al. 2024

PLoS ONE

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Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is characterized by a sudden worsening of chronic obstructive pulmonary disease (COPD) symptoms, which significantly contributes to hospitalizations related to COPD symptoms. Previous research has mainly focused on the correlation between obstructive sleep apnea (OSA) and COPD. However, there were few studies that investigated the short-term mortality rate of AECOPD patients with or without OSA. Methods Data for our research was taken from the Medical Information Mart for Intensive Care Database IV. A total of 1332 patients were included in the study based on well-defined criteria for selection and exclusion. By analyzing the characteristics of AECOPD patients, we compared those with and without OSA. Results There were 1122 AECOPD patients without OSA, 210 patients with OSA. In comparison to those without OSA, patients with OSA exhibited lower 30-day and 90-day ICU mortality with unadjusted HR, as well as lower hospital mortality with unadjusted OR. However, after adjustments were made, there were no significant associations observed between OSA and short-term mortality, including 30-day ICU mortality, 90-day ICU mortality, ICU mortality, and hospital mortality in AECOPD patients. Subgroup analysis revealed that OSA may act as a risk factor for AECOPD patients with a BMI lower than 30 kg/m2. Conclusions There is no impact on short-term survival in AECOPD patients with OSA under intensive care unit (ICU) management and nursing.

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Section: Discussionmentioning

confidence: 99%

Exploring the impact of OSA on short-term survival in patients with AECOPD admitted to the ICU

Liu,

Chen,

et al. 2024

PLoS ONE

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“…Obstructive sleep apnea (OSA), which is characterized by recurrent, partial, or total collapse of the upper airway with resultant sleep structure abnormalities and nocturnal hypoxemia, is common in both COPD and ILD. 2,3 The clinical and prognostic effect of OSA on CRDs has been investigated, with some studies demonstrating an association of OSA with worse quality of life and higher mortality. 4,5 Some reports have tried to explore the predictors in order to identify OSA among these patients.…”

Section: Introductionmentioning

confidence: 99%

Obstructive Sleep Apnea in Patients With Fibrotic Interstitial Lung Disease and COPD

Zhang

Dai

Zhang

et al. 2019

Journal of Clinical Sleep Medicine

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Study Objectives: Despite the clinical and prognostic significance of obstructive sleep apnea (OSA) in chronic respiratory diseases (CRDs), there have been few studies about the possible predictors of OSA and the effect of OSA on quality of life in patients with CRDs. The objectives were to identify physiological and clinical parameters that predict the occurrence and severity of OSA and to investigate the effect of OSA on quality of life in patients with CRDs. Methods: Seventy-three patients with chronic obstructive pulmonary disease (COPD) and 77 patients with fibrotic interstitial lung disease (ILD) underwent overnight polysomnography (PSG) and pulmonary function testing and completed clinical questionnaires. The oximetry tracing was interpreted blindly with respect to the PSG results. Results: The prevalence of OSA was 44% and 62% in COPD and ILD, respectively. The COPD assessment test item scores related to sleep quality and daily vitality were worse among patients with OSA than among patients without OSA. The STOP-BANG questionnaire (cutoff point ≥ 3) and oxygen desaturation index from the oximetry recording (oxygen desaturation index (ODI) were associated with OSA in CRDs. The STOP-BANG questionnaire with a cutoff point ≥ 3 or 6 had the highest sensitivity and specificity, respectively, in detecting OSA in CRDs. ODI had the best accuracy in identifying OSA and was independently associated with the apnea-hypopnea index in CRDs. Conclusions: We found OSA to be common and associated with worse sleep quality and less daily vitality in patients with advanced CRDs. The STOP-BANG questionnaire with different cutoff points may help rule in or rule out OSA. Overnight oximetry can be used as a screening tool for OSA and can assist the clinical evaluation of OSA in patients with CRDs.

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“…The prevalence of obstructive sleep apnea (OSA) among patients with moderate to severe chronic obstructive pulmonary disease (COPD) may be as high as 65% (1,2). The true prevalence of OSA-COPD overlap syndrome may be even higher because traditional tools and surveys used to screen for OSA tend to focus on typical symptoms and may not capture the predominant presentations in patients with underlying lung disease (3).…”

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confidence: 99%

Effects of Obstructive Sleep Apnea and Obesity on 30-Day Readmissions in Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Mediation Analysis

Channick¹,

Jackson

Zeidler³

et al. 2022

Annals ATS

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Rationale: Comorbidity is a significant driver of health status and healthcare utilization in chronic obstructive pulmonary disease (COPD). Obstructive sleep apnea (OSA) portends poorer outcomes, whereas obesity is protective.Objectives: We describe the prevalence and influence of these comorbidities on COPD readmissions.Methods: We collated discharge records for COPD exacerbations spanning 2010-2016 from the Nationwide Readmissions Database using Medicare's Hospital Readmissions Reduction Program criteria, with OSA-COPD overlap identified by concomitant diagnosis code for OSA. We used mixed-effects logistic regression to predict readmission odds. A cross-sectional mediation analysis was performed to evaluate the extent that OSA attenuated obesity's impact on readmission.Results: Of 1,662,983 qualifying COPD discharges, 19.1% carried a diagnosis of obesity and 12.9% had OSA, with both diagnoses present in 7.8%. In unadjusted analyses, obesity (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03-1.05; P , 0.001) and OSA (OR, 1.11; 95% CI, 1.10-1.13; P , 0.001) had increased readmission odds. In models adjusted for patient and hospital characteristics, 71% of readmission risk from obesity was attributable to OSA. When additionally adjusted for Charlson Comorbidity Index, we found that OSA remained a significant risk factor (OR, 1.05; 95% CI, 1.03-1.06; P , 0.001), whereas obesity remained protective (OR, 0.96; 95% CI, 0.94-0.97; P , 0.001) even after accounting for OSA.Conclusions: A significant proportion of patients with COPD suffer comorbid OSA and obesity with resultant readmission risk. Interestingly, obesity's protective effect attenuates readmission odds from OSA. Taken together, OSA and aggregate comorbidity influence readmissions in patients with COPD. Testing for and treating OSA-COPD overlap may provide a mechanism to reduce avoidable readmissions.

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OSA/COPD Overlap: Convergence on a Theme?

Abstract: The authors have seen and approved the manuscript. Dr. Wickwire's institution has received research funding from Merck and ResMed. Dr. Wickwire has served as a scientific consultant for DayZz and Merck and is an equity shareholder in WellTap. Dr. Dorsch reports no conflicts of interest.

Cited by 7 publications

References 17 publications

Exploring the impact of OSA on short-term survival in patients with AECOPD admitted to the ICU

Exploring the impact of OSA on short-term survival in patients with AECOPD admitted to the ICU

Obstructive Sleep Apnea in Patients With Fibrotic Interstitial Lung Disease and COPD

Effects of Obstructive Sleep Apnea and Obesity on 30-Day Readmissions in Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Mediation Analysis

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