Outcomes Important to Patients Diagnosed with Both COPD and Sleep Apnea: Findings from the O2VERLAP Study Focus Groups

Sullivan, Jamie; Pasquale, Cara; Clark, Bill; Malanga, Elisha; Martinez, Suzanna M.; Mannino, David M.; Stepnowsky, Carl

doi:10.15326/jcopdf.2021.0268

Cited by 2 publications

(1 citation statement)

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“…Among patients with respiratory/ventilatory impairment, it has been noted that some patients may have difficulty in acclimatising, potentially due to experiencing the perception of asphyxiation and breathing impairment when first introduced to CPAP therapy. 33 , 66 Among Aboriginal Australian patients with COPD, symptoms of cough, wheeze and sputum production are particularly prevalent and thus may present as a barrier to CPAP use. 33 , 67 Our study findings indicate that in the combined presence of a higher burden of respiratory comorbidities alongside significant spirometry impairment among remote residing Aboriginal population may hamper long-term adherence to CPAP therapy.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Lung Function Parameters on Sleep Among Aboriginal Australians – A Polysomnography and Spirometry Relationship Study

Howarth¹,

Saad²,

Heraganahally³

2023

NSS

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Background Sleep disorders such as obstructive sleep apnoea (OSA) are known to overlap significantly with airway diseases in various populations. This study assessed the relationship between lung function parameters against polysomnography (PSG) and continuous positive airway pressure (CPAP) adherence data amongst an Aboriginal Australian population. Methods Patients who undertook both a diagnostic PSG and spirometry were included. Restrictive, obstructive, and mixed impairments were assessed via global lung function initiative (GLI-2012, ATS/ERS) criteria/guidelines. PSG and CPAP data were evaluated between patients with or without spirometry impairments. Results Of the total 771 patients, 248 had PSG and spirometry data available (52% female, 44% remote residents, 78% obese). The majority (89%) had OSA (51% severe), 95 (38%) were observed to have a restrictive impairment, and 31 (13%) had an obstructive or mixed impairment on spirometry. Compared to patients with no spirometric impairment, those with restrictive or obstructive/mixed impairments demonstrated significantly lower sleep efficiency (median 84% vs 79% and 78%), higher apnoea-hypopnea index (AHI) during rapid eye movement (REM) sleep (median 32 vs 52 and 55 events/hour), reduced REM oxygen saturation (SpO 2 ) (median 94.0% vs 92.0% and 92.5%) and reduced adherence to CPAP therapy (median 39% vs 22% and 17%). Differences in sleep efficiency, REM AHI, and NREM SpO 2 held for patients with obstructive/mixed impairments in multivariate modelling. Conclusion Aboriginal Australian patients with OSA have a higher concurrent lung function’ impairment. Spirometric impairment appears to negatively influence sleep efficiency, nocturnal SpO 2 and CPAP adherence. This may have substantial implications for OSA management among Aboriginal Australians.

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Section: Discussionmentioning

confidence: 99%