[COPD and sleep apnea-hypopnea syndrome]

Abstract

Overlap syndrome refers to the coexistence of COPD and obstructive sleep apneas-hypopneas in the same patient. This syndrome affects 1% of the adult population. There is no particular clinical presentation but patients with overlap syndrome show COPD with disproportionate hypercapnia, hypoxemia and dyspnea. These patients usually report loud snoring, poor quality of sleep and daytime drowsiness. There is also a tendency to rapidly develop pulmonary hypertension. The natural history of the syndrome is largely unknown but some preliminary results from the Zaragoza Sleep Cohort Study indicate a high probability of long-term cardiovascular mortality in patients with overlap syndrome not treated with non-invasive ventilation. Treatment of the syndrome is nonspecific. The treatment of overlap syndrome is specific to each of the two components and consequently the management of COPD should be individually tailored and the severity of obstructive sleep apnea-hypopnea syndrome and response to non-invasive ventilation should be evaluated.