New developments in the management of chronic obstructive pulmonary disease and the overlap syndrome.

OPINION STATEMENT: The "overlap syndrome" is the concurrence of chronic obstructive pulmonary disease (COPD) with obstructive sleep apnea (OSA). This condition is not particularly well defined, and there is a paucity of data about the effects of any specific treatment on its outcomes. Until now, optimum treatment of the overlap syndrome could probably be best described as optimum treatment of each of its components, and there was no specific reason to think that treating one part of the syndrome would ameliorate the other part. However, recent observational data have demonstrated improved survival and reduced exacerbations in patients with the overlap syndrome who are treated with continuous positive airway pressure (CPAP). Physicians caring for patients with COPD should screen for OSA and have a low threshold for initiating CPAP treatment in those COPD patients who are found to have OSA.