How obstructive sleep apnea differs in COPD and asthma: insights from a clinical and functional study
Antonio Fabozzi1, Alessia Steffanina2, Ambra Nicolai2
1Pulmonology Division, Department of Public Health and Infectious Diseases, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico, 155, Rome, 00161, Italy. antonio.fabozzi@uniroma1.it.
Background:
Direct comparisons between Overlap Syndrome (OVS), the concomitance of obstructive sleep apnea (OSA) with chronic obstructive pulmonary disease (COPD), and alternative Overlap Syndrome (aOVS), the concomitance of OSA with asthma, are limited.
Objective:
To describe clinical and respiratory differences between OVS and aOVS.
Methods:
This retrospective single-centre study included 66 patients with OVS and 35 patients with aOVS. All patients underwent Home Sleep Apnea test (HSAT) and spirometry. Predicted Low arousal threshold (LowAT) was estimated using validated predictive models based on HSAT criteria.
Results:
Patients with OVS exhibited significantly higher Apnea-Hypopnea Index (AHI), oxygen desaturation index (ODI) and Time spent with SpO2 < 90% (T90%) compared to aOVS. aOVS was associated with significantly higher odds of night-time awakenings, insomnia symptoms and fatigue. Predicted LowAT occured in 57.1% of aOVS and in 30.3% of OVS.
Conclusions:
OVS showed greater nocturnal hypoxemia and respiratory events, whereas aOVS showed more frequently recorded awakenings, insomnia symptoms and fatigue. The trend emerging from the differing prevalence of predicted LowAT appears interesting but is currently exploratory. Future prospective studies involving large cohorts will be needed to verify the true prevalence of LowAT in these two populations.
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