Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 18:15:605-611.
doi: 10.2147/COPD.S243429. eCollection 2020.

The Bronchiectasis in COPD-OSA Overlap Syndrome Patients

Xia Yang  1 , Xin Tang  1 , Yaoqian Cao  1 , Lixia Dong  1 , Yan Wang  1 , Jing Zhang  1 , Jie Cao  1
Affiliations

The Bronchiectasis in COPD-OSA Overlap Syndrome Patients

Xia Yang et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: COPD-OSA (chronic obstructive pulmonary disease-obstructive sleep apnea) overlap syndrome is associated with more frequent COPD acute exacerbations than COPD without OSA. With the application of high-resolution computed tomography (HRCT) in COPD, bronchiectasis is commonly detected and is associated with disease severity. Sleep respiratory disease is also associated with bronchiectasis; however, the correlation between OSA and coexisted bronchiectasis in COPD (COPD-Bx) has not been reported yet.

Patients and methods: A total of 124 consecutive patients with stable COPD were enrolled. All subjects completed the chest HRCT and nocturnal polysomnography (PSG). The scores of extent and severity in bronchiectasis were assessed based on the Smith method and the Bhalla scoring system. Clinical data, questionnaire, routine blood test data, blood levels of C-reactive protein (CRP) and Immunoglobulin E, and the lymphocyte subtype were collected.

Results: Among all enrolled patients, 56.45% (70/124) were diagnosed as COPD-OSA based on the results of PSG screening. Bronchiectasis was detected in 42.86% (30/70) of the patients with COPD-OSA, but in 18.52% (10/54) of the patients without OSA (χ2=8.264, p=0.004). PSG screening revealed that COPD with OSA had a significantly higher apnea-hypopnea index and percent of time spent with oxygen saturation below 90% (T90). Higher values of CRP, T90, and lower CD4/CD8 in the COPD-Bx with OSA were detected compared to COPD-Bx without OSA. Correlation analysis showed that the Bhalla severity score was related to CD8 cell count (r=0.446, p<0.05) and CD4/CD8 (r=-0.357, p<0.05) in all the COPD-Bx patients. The Smith extent score was also associated with the values of CD8 count (r=0.388, p<0.05) and CD4/CD8 (r=-0.381, p<0.05).

Conclusion: The comorbid bronchiectasis was more common in COPD-OSA overlap syndrome patient and may be related to more severe hypoxia and increased systemic inflammation.

Keywords: bronchiectasis; chronic obstructive pulmonary disease; obstructive sleep apnea.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chaouat A, Weitzenblum E, Krieger J, Ifoundza T, Oswald M, Kessler R. Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am J Respir Crit Care Med. 1995;151(1):82–86. doi:10.1164/ajrccm.151.1.7812577 - DOI - PubMed
    1. Shawon MS, Perret JL, Senaratna CV, Lodge C, Hamilton GS, Dharmage SC. Current evidence on prevalence and clinical outcomes of co-morbid obstructive sleep apnea and chronic obstructive pulmonary disease: a systematic review. Sleep Med Rev. 2017;32:58–68. doi:10.1016/j.smrv.2016.02.007 - DOI - PubMed
    1. Sanders MH, Newman AB, Haggerty CL, et al. Sleep Heart Health Study. Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med. 2003;167(1):7–14. doi:10.1164/rccm.2203046 - DOI - PubMed
    1. López-Acevedo MN, Torres-Palacios A, Elena Ocasio-Tascón M, Campos-Santiago Z, Rodríguez-Cintrón W. Overlap syndrome: an indication for sleep studies?: A pilot study. Sleep Breath. 2009;13(4):409–413. doi:10.1007/s11325-009-0263-5 - DOI - PubMed
    1. Soler X, Gaio E, Powell FL, et al. High prevalence of obstructive sleep apnea in patients with moderate to severe chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2015;12(8):1219–1225. doi:10.1513/AnnalsATS.201506-379LE - DOI - PMC - PubMed

MeSH terms