Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome.
<h4>Background</h4>More advanced knowledge is needed on how COPD alters the clinical presentation of obstructive sleep apnea (OSA) and how the association of both diseases, known as 'overlap syndrome' (OVS), impacts on cardiovascular health.<h4>Objective</h4>To inve...
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Public Library of Science (PLoS)
2020-01-01
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| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0235331&type=printable |
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| author | Dan Adler Sébastien Bailly Meriem Benmerad Marie Joyeux-Faure Ingrid Jullian-Desayes Paola Marina Soccal Jean Paul Janssens Marc Sapène Yves Grillet Bruno Stach Renaud Tamisier Jean-Louis Pépin |
| author_facet | Dan Adler Sébastien Bailly Meriem Benmerad Marie Joyeux-Faure Ingrid Jullian-Desayes Paola Marina Soccal Jean Paul Janssens Marc Sapène Yves Grillet Bruno Stach Renaud Tamisier Jean-Louis Pépin |
| author_sort | Dan Adler |
| collection | DOAJ |
| description | <h4>Background</h4>More advanced knowledge is needed on how COPD alters the clinical presentation of obstructive sleep apnea (OSA) and how the association of both diseases, known as 'overlap syndrome' (OVS), impacts on cardiovascular health.<h4>Objective</h4>To investigate differences between patients with OVS and those with moderate-to-severe OSA alone.<h4>Methods</h4>A cross-sectional study conducted in the French National Sleep Apnea Registry between January 1997 and January 2017. Univariable and multivariable logistic regression models were used to compare OVS versus OSA alone on symptoms and cardiovascular health.<h4>Results</h4>46,786 patients had moderate-to-severe OSA. Valid spirometry was available for 16,466 patients: 14,368 (87%) had moderate-to-severe OSA alone and 2098 (13%) had OVS. A lower proportion of OVS patients complained of snoring, morning headaches and excessive daytime sleepiness compared to OSA alone (median Epworth Sleepiness Scale score: 9 [interquartile range (IQR) 6-13] versus 10 (IQR 6-13), respectively; P <0.02). Similarly, a lower proportion of OVS patients (35.6% versus 39.4%, respectively; P <0.01) experienced sleepiness while driving. In contrast, 63.5% of the OVS population experienced nocturia compared to 58.0% of the OSA population (P<0.01). Apnea hypopnea index (36 [25; 52] vs 33.1 [23.3; 50]), oxygen desaturation index (28 [15; 48] vs 25.2 [14; 45]) and mean nocturnal SaO2 (92 [90; 93.8] vs 93 [91.3; 94]) were significantly more altered in the OVS group. Associated COPD had no effect on the prevalence of hypertension and stroke. After controlling for main confounders, COPD severity was associated in a dose-response relationship with a higher prevalence of coronary heart disease, heart failure and peripheral arteriopathy.<h4>Conclusions</h4>In adults with moderate-to-severe OSA, OVS was minimally symptomatic, but exhibited higher odds for prevalent coronary heart disease, heart failure and peripheral arteriopathy. |
| format | Article |
| id | doaj-art-1c439a9b2e27400cbd4757f6c8ccf799 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-1c439a9b2e27400cbd4757f6c8ccf7992025-08-20T02:00:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01157e023533110.1371/journal.pone.0235331Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome.Dan AdlerSébastien BaillyMeriem BenmeradMarie Joyeux-FaureIngrid Jullian-DesayesPaola Marina SoccalJean Paul JanssensMarc SapèneYves GrilletBruno StachRenaud TamisierJean-Louis Pépin<h4>Background</h4>More advanced knowledge is needed on how COPD alters the clinical presentation of obstructive sleep apnea (OSA) and how the association of both diseases, known as 'overlap syndrome' (OVS), impacts on cardiovascular health.<h4>Objective</h4>To investigate differences between patients with OVS and those with moderate-to-severe OSA alone.<h4>Methods</h4>A cross-sectional study conducted in the French National Sleep Apnea Registry between January 1997 and January 2017. Univariable and multivariable logistic regression models were used to compare OVS versus OSA alone on symptoms and cardiovascular health.<h4>Results</h4>46,786 patients had moderate-to-severe OSA. Valid spirometry was available for 16,466 patients: 14,368 (87%) had moderate-to-severe OSA alone and 2098 (13%) had OVS. A lower proportion of OVS patients complained of snoring, morning headaches and excessive daytime sleepiness compared to OSA alone (median Epworth Sleepiness Scale score: 9 [interquartile range (IQR) 6-13] versus 10 (IQR 6-13), respectively; P <0.02). Similarly, a lower proportion of OVS patients (35.6% versus 39.4%, respectively; P <0.01) experienced sleepiness while driving. In contrast, 63.5% of the OVS population experienced nocturia compared to 58.0% of the OSA population (P<0.01). Apnea hypopnea index (36 [25; 52] vs 33.1 [23.3; 50]), oxygen desaturation index (28 [15; 48] vs 25.2 [14; 45]) and mean nocturnal SaO2 (92 [90; 93.8] vs 93 [91.3; 94]) were significantly more altered in the OVS group. Associated COPD had no effect on the prevalence of hypertension and stroke. After controlling for main confounders, COPD severity was associated in a dose-response relationship with a higher prevalence of coronary heart disease, heart failure and peripheral arteriopathy.<h4>Conclusions</h4>In adults with moderate-to-severe OSA, OVS was minimally symptomatic, but exhibited higher odds for prevalent coronary heart disease, heart failure and peripheral arteriopathy.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0235331&type=printable |
| spellingShingle | Dan Adler Sébastien Bailly Meriem Benmerad Marie Joyeux-Faure Ingrid Jullian-Desayes Paola Marina Soccal Jean Paul Janssens Marc Sapène Yves Grillet Bruno Stach Renaud Tamisier Jean-Louis Pépin Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome. PLoS ONE |
| title | Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome. |
| title_full | Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome. |
| title_fullStr | Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome. |
| title_full_unstemmed | Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome. |
| title_short | Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome. |
| title_sort | clinical presentation and comorbidities of obstructive sleep apnea copd overlap syndrome |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0235331&type=printable |
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