Phenotype of the combination of chronic obstructive pulmonary disease and sleep apnea – cross-over syndrome

Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are common diseases, and their combination is called overlap syndrome (OS) and is distinguished as a separate phenotype. Physiological disturbances observed during sleep in patients with COPD and OSA include increased upper airway resistance, ineffective gas exchange, and effects on central sleep regulation. Patients with OSA are at higher risk of atrial fibrillation, cardiovascular events, including fatal ones (sudden cardiovascular death), and the risk of developing pulmonary hypertension more often than patients with COPD alone or isolated OSA. The article presents the pathophysiology of respiratory disturbances in patients with OSA during sleep, epidemiological studies, clinical implications, and factors influencing the association of COPD with OSA. It is necessary to use screening questionnaires to identify patients for in-depth diagnostics of OSA, and the clinician should also pay attention to clinical signs defined as indications for the assessment of possible sleep-disordered breathing in COPD. Treatment of OSA in patients with COPD can reduce cardiovascular mortality and improve survival in these patients. Therapy for patients with OS, along with lifestyle changes, includes respiratory support methods: supplemental oxygen therapy, treatment with continuous positive airway pressure (CPAP), non-invasive ventilation (NIV). Bronchodilators and corticosteroids may be appropriate as drugs for drug therapy of SP.

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