Insights into the Overlap of Chronic Obstructive Pulmonary Disease and Sleep Apnea: Experience from the Clinic of Pneumology, Târgu Mureș
Abstract
:1. Introduction
2. Materials and Methods
3. Results
- (a)
- Symptoms—CAT (COPD assessment test): <10—gr. of risk A, >10—gr. of risk B.
- (b)
- Number of exacerbations in the previous year: ≥2 moderate exacerbation or 1 severe with hospitalization = gr. of risk E.
- (c)
- Presence of comorbidities.
- (d)
- Spirometry quantified the severity of airflow obstruction by analyzing the main parameter (FEV1).In our study, patients with an advanced disease predominated with group E identified in 61.7% of patients, with multiple exacerbations and comorbidities.
- (a)
- Exaggerated dyspnea on exertion.
- (b)
- Severe obesity, mainly troncular/abdominal.
- (c)
- Facial plethora (polycythemia and hypercapnia by vasodilation).
- (d)
- Awake room air peripheral saturation (SpO2) ≤ 94 percent or an overnight nadir saturation < 80 percent.
- (e)
- High desaturation on polygraphy (under 90%–around 30% from the night).
- (f)
- Raised bicarbonate over 26 mmol/L or base excess >3 mmol/L in the absence of another cause for a metabolic alkalosis in an obese individual.
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total Patients n = 68 | Females n = 20 | Males n = 48 | p/OR (CI 95%) | |
---|---|---|---|---|
Smoking | 52 (76.4%) | 12 (60%) | 40 (83.3%) | 0.04/3.33 (1.03–10.77) |
Ambiental and professional exposure (pesticides, dilutant in leather industry, biomass burning, second hand smoking, exhaust gases) | 41 (60.29%) | 8 (40%) | 33 (68.7%) | 0.03/3.30 (1.11–9.74) |
Alcohol consumption | 42 (61.7%) | 4 (20%) | 38 (55.8%) | <0.001/15.20 (4.14–55.68) |
Overweight | 17 (25%) | 4 (20%) | 13 (27%) | 0.54/1.48 (0.41–5.27) |
Obesity | 49 (72.05%) | |||
Obesity degree 1 | 11 (16.17%) | 2 (10%) | 9 (13.23%) | 0.10 |
Obesity degree 2 | 26 (38.2%) | 12 (60%) | 14 (29.16%) | |
Obesity degree 3 | 12 (17.6%) | 2 (10%) | 10 (20.8%) |
38–50 Years Old | 51–65 Years Old | 66–70 Years Old | Over 71 Years Old | p | |
---|---|---|---|---|---|
Women | 2 (10%) | 4 (20%) | 8 (40%) | 6 (30%) | <0.001 |
Males | 7 (14.58%) | 34 (70.83%) | 4 (8.33%) | 3 (6.25%) | |
Total | 9 (13.2%) | 38 (55.8%) | 12 (17.6%) | 9 (13.2%) |
Total Patients n = 68 | COPD gr. of Risk A n = 5 | COPD gr of Risk B n = 21 | COPD gr. of Risk E n = 42 | p | |
---|---|---|---|---|---|
Snoring | 68 (100%) | 5 (100%) | 21 (100%) | 42 (100%) | 1.00 |
Nonrestorative sleep | 68 (100%) | 5 (100%) | 21 (100%) | 42 (100%) | 1.00 |
Awakening with gasping or choking | 28 (41.17%) | 0 (0%) | 8 (38.09%) | 20 (47.61%) | 0.43 |
Nocturnal dyspnea | 24 (35.29%) | 0 (0%) | 3 (14.2%) | 21 (50%) | 0.01 |
Morning headaches | 22 (32.3%) | 0 (0%) | 5 (23.80%) | 17 (40.47%) | 0.33 |
Daytime sleepiness or fatigue, | 50 (73.5%) | 2 (40% | 15 (71.42%) | 33 (78.57%) | 0.17 |
Poor concentration or memory impairment | 59 (86.7%) | 5 (100%) | 20 (95.23%) | 34 (80.95%) | 0.30 |
Obstructive Sleep Apnea or Mixt Sleep Apnea | Central Sleep Apnea | Associated Obesity–Hypoventilation Syndrome | p for OHS/OR (CI95%) | |
---|---|---|---|---|
Women n = 20 | 20 (100%) | 0 (0%) | 2 (10%) | <0.001/11.84 (2.44–57.37) |
Males n = 48 | 46 (95.83%) | 2 (4.16%) | 25 (52.03%) | |
Total n = 68 | 66 (97.05%) | 2 (2.94%) | 27 (39.7%) |
Total n = 68 | COPD + OSA Without OHS n = 41 | COPD + OSA + OHS n = 27 | p/OR (CI 95%) | |
---|---|---|---|---|
Respiratory failure | 28 (41%) | 3 (7.31%) | 25 (92.59%) | <0.0001/158.30 (24.67–1016.13) |
Respiratory failure + NIV need (6 in ICU) | 10 (14.7%) | 2 (4.87%) | 8 (29.62%) | 0.01/8.21 (1.58–42.48) |
Systemic hypertension | 63 (92.64%) | 38 (92.68%) | 25 (92.59%) | 0.98/0.98 (0.15–6.33) |
Ischemic cardiac disease | 40 (58.8%) | 20 (48.78%) | 20 (74.07%) | 0.04/3.00 (1.04–8.62) |
Arrythmia | 14 (20.58%) | 8 (19.5%) | 12 (44.4%) | 0.03/3.30 (1.11–9.74) |
Cor pulmonale | 30 (44.11%) | 13 (31.7%) | 17 (62.96%) | 0.01/3.66 (1.31–10.16) |
Diabetes mellitus | 29 (42.64%) | 14 (34.1%) | 13 (48.1%) | 0.25/1.79 (0.66–4.83) |
Dyslipidemia | 44 (64.7%) | 21 (51.21%) | 23 (85.18%) | <0.01/5.47 (1.60–18.65) |
Increased risk for respiratory infection and COPD exacerbation (≥2/year) | 40 (58.8%) | 21 (51.21%) | 19 (70.37%) | 0.11/2.26 (0.80–6.32) |
Cognitive decline: loss of concentration, mood swings, memory troubles, insomnia | 48 (70.5%) | 23 (56%) | 25 (92.59%) | <0.01/10.32 (2.16–49.29) |
Males n = 48 | Females n = 20 | p/OR (CI 95%) | |
---|---|---|---|
Epworth scale score ≥ 10 pts | 41 (85.41%) | 18 (90%) | 0.61/0.65 (0.12–3.44) |
STOP-BANG scale score > 4 pts | 44 (91.66%) | 16 (80%) | 0.18/2.75 (0.61–12.31) |
Mild OSA (AHI < 15) | Moderate OSA (15 ≤ AHI ≤ 30) | Severe OSA (AHI < 30) | |
---|---|---|---|
Total patients n = 68 | - | 10 (14.70%) | 58 (85.30%) |
Obesity–hypoventilation syndrome n = 27 | - | - | 27 (100%) |
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Ianoși, E.S.; Zsuzsánna, G.; Rachiș, D.; Huțanu, D.; Budin, C.; Postolache, P.; Jimborean, G. Insights into the Overlap of Chronic Obstructive Pulmonary Disease and Sleep Apnea: Experience from the Clinic of Pneumology, Târgu Mureș. Clin. Pract. 2024, 14, 2300-2312. https://doi.org/10.3390/clinpract14060180
Ianoși ES, Zsuzsánna G, Rachiș D, Huțanu D, Budin C, Postolache P, Jimborean G. Insights into the Overlap of Chronic Obstructive Pulmonary Disease and Sleep Apnea: Experience from the Clinic of Pneumology, Târgu Mureș. Clinics and Practice. 2024; 14(6):2300-2312. https://doi.org/10.3390/clinpract14060180
Chicago/Turabian StyleIanoși, Edith Simona, Gall Zsuzsánna, Delia Rachiș, Dragoș Huțanu, Corina Budin, Paraschiva Postolache, and Gabriela Jimborean. 2024. "Insights into the Overlap of Chronic Obstructive Pulmonary Disease and Sleep Apnea: Experience from the Clinic of Pneumology, Târgu Mureș" Clinics and Practice 14, no. 6: 2300-2312. https://doi.org/10.3390/clinpract14060180