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. 2023 Mar;17(3):165-175.
doi: 10.1111/crj.13580. Epub 2023 Jan 12.

Effect of compliance to continuous positive airway pressure on exacerbations, lung function and symptoms in patients with chronic obstructive pulmonary disease and obstructive sleep apnea (overlap syndrome)

Athanasios Voulgaris  1   2 , Kostas Archontogeorgis  2 , Stavros Anevlavis  1 , Michail Fanaridis  3 , Marios E Froudarakis  1 , Sofia Schiza  3 , Paschalis Steiropoulos  1   2
Affiliations

Effect of compliance to continuous positive airway pressure on exacerbations, lung function and symptoms in patients with chronic obstructive pulmonary disease and obstructive sleep apnea (overlap syndrome)

Athanasios Voulgaris et al. Clin Respir J. 2023 Mar.

Abstract

Introduction: Patients with overlap syndrome (OS), that is obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), are at increased risk of acute exacerbations related to COPD (AECOPD). We assessed the effect of CPAP compliance on AECOPD, symptoms and pulmonary function in OS patients.

Methods: Consecutive OS patients underwent assessment at baseline and at 12 months under treatment with CPAP of: AECOPD and hospitalizations, COPD Assessment Test (CAT) and modified British Medical Research Council (mMRC) questionnaires, pulmonary function testing and 6-min walking test (6MWT).

Results: In total, 59 patients (54 males) with OS were followed for 12 months and divided post hoc according to CPAP compliance into: group A with good (≥4 h CPAP use/night, n = 29) and group B with poor (<4 h CPAP use/night, n = 30) CPAP compliance. At 12 months, group A showed improvements in FEV1 (p = 0.024), total lung capacity (p = 0.024), RV/TLC (p = 0.003), 6MWT (p < 0.001) and CAT (p < 0.001). COPD exacerbations decreased in patients with good CPAP compliance from baseline to 12 months (17 before vs. 5 after, p = 0.001), but not in those with poor compliance (15 before vs. 15 after, p = 1). At multivariate regression analysis, COPD exacerbations were associated with poor CPAP compliance (β = 0.362, 95% CI: 0.075-0.649, p = 0.015).

Conclusions: When compared to poorly compliant patients, OS patients with good CPAP compliance had a lower number of AECOPD and showed improved lung function and COPD related symptoms.

Keywords: chronic obstructive pulmonary disease; compliance; continuous positive airway pressure; exacerbations; obstructive sleep apnea; overlap syndrome.

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Conflict of interest statement

The authors do not have any conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
The study flowchart. COPD, chronic obstructive pulmonary disease; CPAP, continuous positive airway pressure; OS, overlap syndrome; OSA, obstructive sleep apnea
See this image and copyright information in PMC

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