Published April 28, 2023 | Version v1
Journal article Open

Chronic Obstructive Pulmonary Disease and Sleep Apnea Syndrome – a Multidisciplinary Problem of Clinical Medicine

Creators

  • 1. Ivano-Frankivsk National Medical University, Ukraine

Description

Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are more common pathologies in clinical practice, which are accompanied very often by cardiovascular comorbidity.

The objective: to analyze the clinical features of chronic obstructive pulmonary disease course in combination with the risk of sleep apnea syndrome.

Materials and methods. 47 patients with COPD III degree of bronchial obstruction, group E participated in the study: 9 (19.1%) women and 38 (80.9%) men. The study participants were divided into two groups: I group (COPD) – 32 persons, II group (COPD + apnea syndrome) – 15 individuals.

Clinical, spirographic laboratory, X-ray, ultrasound, and electrocardiographic examinations were performed to the patients, the STOP-Bang questionnaire was used to determine the risk of sleep apnea syndrome development, and the influence of bronchial obstruction on the daytime sleepiness (Epworth scale) and depression (Beck questionnaire) was studied.

Results. The analysis of the results of the study presented that among the examined patients with COPD 32 (68.1%) subjects were identified with a high risk of sleep apnea syndrome. In this cohort of patients there were signs of daytime sleepiness according to the Epworth scale, and according to the Beck questionnaire they scored more than 10 points, that is, a mild level of depression of situational or neurotic origin was found.

It was found that among patients with COPD in combination with the risk of night apnea (II group), coronary heart disease was diagnosed in 24 (75%) cases, arterial hypertension – in 22 (68.8%) cases, diabetes – in 15 (46.9%). At the same time, the prevalence of these nosologies in patients with COPD without the risk of night apnea was significantly (p<0.05) lower. The Charlson comorbidity index in patients with COPD and risk of apnea was within 3–4 points, 10-year survival was within 77–53%.

Conclusions. The high risk of apnea syndrome according to the results of the screening questionnaire, excessive daytime sleepiness, and depressive states in patients with COPD should prompt primary care physicians to refer such patients to a comprehensive polysomnography examination to confirm OSAS. After all, COPD, OSAS and cardiovascular comorbidity are characterized by a more unfavorable clinical course and prognosis than each of these diseases separately.

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