Analysis of risk factors of chronic obstructive pulmonary disease combined with obstructive sleep apnea and its relationship with apnea-hypopnea index_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

HU Yanyan , WANG Wei , PAN Huixian , LI Xiaojun ,  BAI Xiaomin

Department of Respiratory and Respiratory Critical Care, The First Hospital of Handan, Handan, Hebei 056000, P.R China;

Corresponding author：

BAI Xiaomin, Email: 18833902232@163.com

Keywords：

Chronic obstructive pulmonary disease; obstructive sleep apnea; characteristics; influencing factors

DOI：

10.7507/1671-6205.202110015

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the risk factors of chronic obstructive pulmonary disease (COPD) combined with obstructive sleep apnea (OSA) and its relationship with apnea-hypopnea index (AHI). Methods Clinical data of 216 COPD patients with OSA were retrospectively chosen in the period from January 2016 to December 2019 in our hospital. All patients were divided into different groups according to with or without OSA and the clinical features of patients with and without OSA were compared. Multivariate analysis was used to analyze the influencing factors of COPD with OSA and the correlation between AHI and COPD with OSA was also evaluated. Results ① The age, body mass index (BMI), neck circumference, smoking index, forced expiratory volume in 1 second (FEV₁), FEV₁% predicted (FEV₁pred), the ratio of FEV₁ to the forced vital capacity of the lungs (FEV₁/FVC), COPD assessment test (CAT) score, Epworth sleepiness scale (ESS) score, Charlson comorbidity index (CCI) score, sleep apnea clinical score (SACS) score and proportion of patients with essential hypertension in OSA group were significantly higher than non-OSA group (P<0.05). The course of disease and the proportion of severe COPD and GOLD grade 4 in OSA group were significantly less than non-OSA group (P<0.05). ② AHI was positively correlated with age, BMI, neck circumference, smoking index, FEV₁%pred, FEV₁%pred<50%, CAT score, ESS score, CCI score and SACS score (P<0.05); and negatively correlated with FEV₁%pred<50% (P<0.05). ③ Multivariate analysis showed that BMI, FEV₁%pred<50%, CAT score and ESS score were the independent factors of COPD patients with OSA (P<0.05). ④ The proportion of AHI<5 times/h in GOLD grade 4 was significantly higher than GOLD grade 1-3 (P<0.05). The proportion of AHI> 30 times/h in GOLD grade 4 was significantly lower than GOLD grade 1-3 (P<0.05). Conclusion The incidence of COPD with OSA was independently correlated with BMI, FEV₁%pred, CAT score and ESS score; patients with severe COPD possess lower OSA risk.

Citation： HU Yanyan, WANG Wei, PAN Huixian, LI Xiaojun, BAI Xiaomin. Analysis of risk factors of chronic obstructive pulmonary disease combined with obstructive sleep apnea and its relationship with apnea-hypopnea index. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(6): 391-395. doi: 10.7507/1671-6205.202110015 Copy

1.	Tan L, Latshang TD, Aeschbacher SS, et al. Effect of nocturnal oxygen therapy on nocturnal hypoxemia and sleep apnea among patients with chronic obstructive pulmonary disease traveling to 2048 meters: a randomized clinical trial. JAMA Netw Open, 2020, 3(6): e207940.
2.	Shawon MS, Perret JL, Senaratna CV, et al. 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(6): 58-68.
3.	Wu QH, Xie L, Li WJ, et al. Pulmonary function influences the performance of Berlin Questionnaire, Modified Berlin Questionnaire, and STOP-Bang Score for screening obstructive sleep apnea in subjects with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2020, 15(5): 1207-1216.
4.	Du W, Liu J, Zhou JL, et al. Obstructive sleep apnea, COPD, the overlap syndrome, and mortality: results from the 2005-2008 national health and nutrition examination survey. Int J Chron Obstruct Pulmon Dis, 2018, 13(7): 665-674.
5.	Archontogeorgis K, Voulgaris A, Papanas N, et al. Metabolic syndrome in patients with coexistent obstructive sleep apnea syndrome and chronic obstructive pulmonary disease (overlap syndrome). Metab Syndr Relat Disord, 2020, 5(5): 87-90.
6.	中华医学会呼吸病学分会睡眠呼吸障碍学组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版). 中华结核和呼吸杂志, 2012, 35(1): 9-12.
7.	Wang TY, Tsai MH, Ni YL, et al. A simplified screening questionnaire for detecting severe OSA in chronic obstructive airway disease in Asian Population. COPD, 2020, 17(2): 191-196.
8.	Ioachimescu OC, Janocko NJ, Ciavatta MM, et al. Obstructive lung disease and obstructive sleep apnea (OLDOSA) cohort study: 10-year assessment. J Clin Sleep Med, 2020, 16(2): 267-277.
9.	Nobeschi L, Zangirolami-Raimundo J, Cordoni PK, et al. Evaluation of sleep quality and daytime somnolence in patients with chronic obstructive pulmonary disease in pulmonary rehabilitation. BMC Pulm Med, 2020, 20(1): 14-20.
10.	Mehmood M. Obstructive sleep apnea, chronic obstructive pulmonary disease, and heart failure with preserved ejection fraction: a cardiopulmonary perspective. Am J Respir Crit Care Med, 2020, 201(4): 500-509.
11.	Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
12.	Voulgaris A, Archontogeorgis K, Papanas N, et al. Increased risk for cardiovascular disease in patients with obstructive sleep apnoea syndrome-chronic obstructive pulmonary disease (overlap syndrome). Clin Respir J, 2019, 13(11): 708-715.
13.	Kalemci S, Sarıhan A, Zeybek A, et al. Prevalence of pulmonary embolism in patients with obstructive sleep apnea and chronic obstructive pulmonary disease: The overlap syndrome. Heart Lung, 2019, 48(5): 465-471.
14.	Koch AL, Brown RH, Woo H, et al. Obstructive sleep apnea and airway dimensions in chronic obstructive pulmonary disease. Ann Am Thorac Soc, 2020, 17(1): 116-118.
15.	Shaikh M, Sood RG, Sarkar M, et al. Quantitative computed tomography (CT) assessment of emphysema in patients with severe chronic obstructive pulmonary disease (COPD) and its correlation with age, sex, pulmonary function tests, BMI, smoking, and biomass exposure. Pol J Radiol, 2017, 82(6): 760-766.
16.	Xie J. Do obstructive sleep apnea and chronic obstructive pulmonary disease overlap coincidently or intrinsically?. Heart Lung, 2019, 48(5): 466-473.
17.	He BT, Lu G, Xiao SC, et al. Coexistence of OSA may compensate for sleep related reduction in neural respiratory drive in patients with COPD. Thorax, 2017, 72(3): 256-262.
18.	Voulgaris A, Archontogeorgis K, Steiropoulos P, et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease, obstructive sleep apnoea syndrome and overlap syndrome. Curr Vasc Pharmacol, 2020, 17(3): 816-823.

1. Tan L, Latshang TD, Aeschbacher SS, et al. Effect of nocturnal oxygen therapy on nocturnal hypoxemia and sleep apnea among patients with chronic obstructive pulmonary disease traveling to 2048 meters: a randomized clinical trial. JAMA Netw Open, 2020, 3(6): e207940.
2. Shawon MS, Perret JL, Senaratna CV, et al. 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(6): 58-68.
3. Wu QH, Xie L, Li WJ, et al. Pulmonary function influences the performance of Berlin Questionnaire, Modified Berlin Questionnaire, and STOP-Bang Score for screening obstructive sleep apnea in subjects with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2020, 15(5): 1207-1216.
4. Du W, Liu J, Zhou JL, et al. Obstructive sleep apnea, COPD, the overlap syndrome, and mortality: results from the 2005-2008 national health and nutrition examination survey. Int J Chron Obstruct Pulmon Dis, 2018, 13(7): 665-674.
5. Archontogeorgis K, Voulgaris A, Papanas N, et al. Metabolic syndrome in patients with coexistent obstructive sleep apnea syndrome and chronic obstructive pulmonary disease (overlap syndrome). Metab Syndr Relat Disord, 2020, 5(5): 87-90.
6. 中华医学会呼吸病学分会睡眠呼吸障碍学组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版). 中华结核和呼吸杂志, 2012, 35(1): 9-12.
7. Wang TY, Tsai MH, Ni YL, et al. A simplified screening questionnaire for detecting severe OSA in chronic obstructive airway disease in Asian Population. COPD, 2020, 17(2): 191-196.
8. Ioachimescu OC, Janocko NJ, Ciavatta MM, et al. Obstructive lung disease and obstructive sleep apnea (OLDOSA) cohort study: 10-year assessment. J Clin Sleep Med, 2020, 16(2): 267-277.
9. Nobeschi L, Zangirolami-Raimundo J, Cordoni PK, et al. Evaluation of sleep quality and daytime somnolence in patients with chronic obstructive pulmonary disease in pulmonary rehabilitation. BMC Pulm Med, 2020, 20(1): 14-20.
10. Mehmood M. Obstructive sleep apnea, chronic obstructive pulmonary disease, and heart failure with preserved ejection fraction: a cardiopulmonary perspective. Am J Respir Crit Care Med, 2020, 201(4): 500-509.
11. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
12. Voulgaris A, Archontogeorgis K, Papanas N, et al. Increased risk for cardiovascular disease in patients with obstructive sleep apnoea syndrome-chronic obstructive pulmonary disease (overlap syndrome). Clin Respir J, 2019, 13(11): 708-715.
13. Kalemci S, Sarıhan A, Zeybek A, et al. Prevalence of pulmonary embolism in patients with obstructive sleep apnea and chronic obstructive pulmonary disease: The overlap syndrome. Heart Lung, 2019, 48(5): 465-471.
14. Koch AL, Brown RH, Woo H, et al. Obstructive sleep apnea and airway dimensions in chronic obstructive pulmonary disease. Ann Am Thorac Soc, 2020, 17(1): 116-118.
15. Shaikh M, Sood RG, Sarkar M, et al. Quantitative computed tomography (CT) assessment of emphysema in patients with severe chronic obstructive pulmonary disease (COPD) and its correlation with age, sex, pulmonary function tests, BMI, smoking, and biomass exposure. Pol J Radiol, 2017, 82(6): 760-766.
16. Xie J. Do obstructive sleep apnea and chronic obstructive pulmonary disease overlap coincidently or intrinsically?. Heart Lung, 2019, 48(5): 466-473.
17. He BT, Lu G, Xiao SC, et al. Coexistence of OSA may compensate for sleep related reduction in neural respiratory drive in patients with COPD. Thorax, 2017, 72(3): 256-262.
18. Voulgaris A, Archontogeorgis K, Steiropoulos P, et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease, obstructive sleep apnoea syndrome and overlap syndrome. Curr Vasc Pharmacol, 2020, 17(3): 816-823.

Chinese Journal of Respiratory and Critical Care Medicine

Analysis of risk factors of chronic obstructive pulmonary disease combined with obstructive sleep apnea and its relationship with apnea-hypopnea index

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content