The Overlap Syndrome of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease: A Systematic Review

Abstract

Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are common diseases that strongly impact the quality and length of life. Their coexistence is determined by overlap syndrome (OS). This systematic review aims to define the significance of these comorbidities according to the current state of knowledge. For this systematic review, we searched PubMed, Scopus, and Cochrane for studies published between 2018 and 26 October 2022, to find original, observational, human studies published in English, where the diagnosis of COPD was according to the Global Initiative for Obstructive Lung Disease guidelines and the diagnosis of OSA was based on polysomnography. The quality of studies was assessed using the Newcastle–Ottawa quality assessment tool for cohort and case–control studies, as well as its modification for cross-sectional studies. Of the 1548 records identified, 38 were eligible and included in this systematic review. The included studies covered a total population of 27,064 participants. This paper summarizes the most important, up-to-date information regarding OS, including the prevalence, meaning of age/gender/body mass index, polysomnography findings, pulmonary function, comorbidities, predicting OSA among COPD patients, and treatment of this syndrome.

The Interplay between Obstructive Sleep Apnea, Chronic Obstructive Pulmonary Disease, and Congestive Heart Failure: Time to Collectively Refer to Them as Triple Overlap Syndrome?

“…The systematic review by Czerwaty et al [ 10 ] suggests that compared to COPD alone or OSA alone, the OS diagnosis considerably increased the likelihood of developing hypertension. The OS patient had a substantially higher occurrence of coronary heart disease (CHD), including myocardial infarction.…”

Predictive value of red cell distribution width for overlap syndrome in obstructive sleep apnea

“…Taken together with the molecular and clinical evidence, OVS should be recognized early and the diagnosis should not be missed. However, underdiagnosis regarding either OSAS or COPD and OVS as a result, is not rare (20). Although there have been some efforts to identify an inflammatory molecule as a distinguishing biomarker, the and identified lower levels of pre-CPAP ADMA in the OSAS alone group than in the COPD group (24).…”

“…OSAS and COPD are both frequent diseases with marked negative impacts on patients’ QOLs, and they can occur together up to the rates of 11–23% ( 20 ). Concurrence of OSAS and COPD in the same patient is called OVS ( 21 ), and due to a couple of deteriorating mechanisms, including but not limited to systemic inflammation, endothelial dysfunction, and tonic increase in sympathetic activity ( 22 ), OVS is associated with a higher number of vascular risk factors; as well as an increased rate of cardiac/cerebrovascular diseases ( 23 ).…”

Screening and early warning system for chronic obstructive pulmonary disease with obstructive sleep apnoea based on the medical Internet of Things in three levels of healthcare: protocol for a prospective, multicentre, observational cohort study

“… 4 5 The prevalence of OSA among patients with COPD is between 56.45% and 78%, while the coexistence of COPD in patients with OSA leads to a prevalence of 11.9%–23.2%. 14 Given the large populations of COPD and OSA, it is estimated that there is also a huge potential population of OS in China; however, the specific prevalence or epidemiology of OSA among patients with COPD in China is unknown.…”

“…Notably, screening assumes crucial importance, given that improved clinical outcomes have been observed in patients with COPD–OSA overlap on receiving treatment. 15 Although studies have demonstrated the feasibility of questionnaires or portable devices to screen for COPD or OSA, 14 18 19 there has been no effective or appropriate method to identify patients with the combination of both COPD and OSA.…”