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Scientific article
Open access
English

Symptomatic response to CPAP in obstructive sleep apnea versus COPD- obstructive sleep apnea overlap syndrome: Insights from a large national registry

Published inPloS one, vol. 16, no. 8, e0256230
Publication date2021
First online date2021-08-12
Abstract

Background: The symptomatic response to continuous positive airway pressure (CPAP) therapy in COPD-obstructive sleep apnea overlap syndrome (OVS) compared to OSA syndrome (OSA) alone has not been well studied so far. The aim of this study is to explore main differences in the clinical response to CPAP treatment in OVS compared to OSA alone.

Study design and methods: Using prospective data from the French National Sleep Apnea Registry, we conducted an observational study among 6320 patients with moderate-to-severe OSA, available spirometry, and at least one follow-up visit under CPAP therapy.

Results: CPAP efficacy measured on the residual apnea-hypopnea index and median adherence were similar between OVS and OSA patients. In both groups, the overall burden of symptoms related to sleep apnea improved with CPAP treatment. In a multivariable model adjusted for age, gender, body mass index, adherence to treatment and residual apnea-hypopnea index, OVS was associated with higher odds for persistent morning headaches (OR: 1.37 [95% CI; 1.04; 1.79]; P = 0.02), morning tiredness (OR: 1.33 [95% CI: 1.12; 1.59]; P<0.01), daytime sleepiness (OR; 1.24 [95% CI: 1.4; 1.46]: P<0.01) and exertional dyspnea (OR: 1.26 [95% CI: 1.00;1.58]; P = 0.04) when compared with OSA alone.

Interpretation: CPAP therapy was effective in normalizing the apnea-hypopnea index and significantly improved OSA-related symptoms, regardless of COPD status. CPAP should be offered to patients with OVS on a trial basis as a significant improvement in OSA-related symptoms can be expected, although the range of response may be less dramatic than in OSA alone.

eng
Keywords
  • Continuous Positive Airway Pressure / methods
  • Disorders of Excessive Somnolence / physiopathology
  • Disorders of Excessive Somnolence / prevention & control
  • Fatigue / physiopathology
  • Fatigue / prevention & control
  • Female
  • France
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Registries
  • Severity of Illness Index
  • Sleep Apnea Syndromes / physiopathology
  • Sleep Apnea Syndromes / therapy
  • Spirometry
Funding
  • Ligue Pulmonaire Suisse - [LPS-16/12]
  • French National Research Agency - [ANR-15-IDEX-02]
  • MIAI @ Grenoble Alpes - [ANR-19-P3IA-0003]
Citation (ISO format)
ADLER, Dan Elie et al. Symptomatic response to CPAP in obstructive sleep apnea versus COPD- obstructive sleep apnea overlap syndrome: Insights from a large national registry. In: PloS one, 2021, vol. 16, n° 8, p. e0256230. doi: 10.1371/journal.pone.0256230
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Article (Published version)
Identifiers
ISSN of the journal1932-6203
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