Postural balance in COPD with obstructive sleep apnoea: a cross-sectional study.

Area of Science:

• Respiratory Medicine
• Sleep Medicine
• Geriatrics
• Neurology

Background:

• Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition associated with significant morbidity.
• Obstructive sleep apnoea (OSA) is a common comorbidity in COPD patients, potentially exacerbating systemic effects.
• Postural balance deficits and falls are prevalent in COPD, impacting quality of life and increasing healthcare utilization.

Purpose of the Study:

• To investigate the impact of obstructive sleep apnoea (OSA) on postural balance in patients with chronic obstructive pulmonary disease (COPD).
• To evaluate associations between OSA severity and parameters of physical activity, psychological symptoms, and fall history in COPD.
• To determine if OSA influences postural control mechanisms beyond those typically affected in COPD.

Main Methods:

• Seventy moderate to severe COPD patients were assessed using laboratory and clinical postural balance measures (force platform, Mini-BESTest).
• Polysomnography was used to diagnose and categorize OSA severity (no OSA, mild OSA, moderate to severe OSA).
• Assessments included physical activity (accelerometry), sleep quality, sleepiness, anxiety/depression symptoms, dyspnoea, clinical status, mood, and 6-month fall history.

Main Results:

• COPD patients with moderate to severe OSA (msOSA) demonstrated significantly increased path length, anteroposterior displacement, and postural adjustment velocity compared to those without OSA.
• No significant differences in clinical postural balance scores (Mini-BESTest) were found among OSA severity groups.
• The msOSA group reported a higher incidence of recurrent falls within the first follow-up trimester.

Conclusions:

• Moderate to severe OSA in COPD patients is associated with objective impairments in postural control, characterized by broader oscillations and faster adjustments.
• COPD patients with moderate to severe OSA exhibit an elevated risk of falls compared to those without OSA.
• Physical activity, anxiety, depression, and mood did not differ significantly between COPD patients with and without OSA, suggesting OSA's primary impact is on balance and falls.