Dan Adler1,2, Sébastien Bailly3,4, Meriem Benmerad3,4, Marie Joyeux-Faure3,4, Ingrid Jullian-Desayes3,4, Paola Marina Soccal1,2, Jean Paul Janssens1,2, Marc Sapène5, Yves Grillet6, Bruno Stach7, Renaud Tamisier3,4, Jean-Louis Pépin1,3,4. 1. Division of Pneumology, Geneva University Hospitals, Geneva, Switzerland. 2. University of Geneva Faculty of Medicine, Geneva, Switzerland. 3. HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France. 4. EFCR Laboratory, Pole Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France. 5. Private Practice Sleep and Respiratory Disease Centre, Nouvelle Clinique Bel Air, Bordeaux, France. 6. Private Practice Sleep and Respiratory Disease Centre, Valence, France. 7. Private Practice Sleep and Respiratory Disease Centre, Valenciennes, France.
Abstract
BACKGROUND: More advanced knowledge is needed on how COPD alters the clinical presentation of obstructive sleep apnea (OSA) and how the association of both diseases, known as 'overlap syndrome' (OVS), impacts on cardiovascular health. OBJECTIVE: To investigate differences between patients with OVS and those with moderate-to-severe OSA alone. METHODS: A cross-sectional study conducted in the French National Sleep Apnea Registry between January 1997 and January 2017. Univariable and multivariable logistic regression models were used to compare OVS versus OSA alone on symptoms and cardiovascular health. RESULTS: 46,786 patients had moderate-to-severe OSA. Valid spirometry was available for 16,466 patients: 14,368 (87%) had moderate-to-severe OSA alone and 2098 (13%) had OVS. A lower proportion of OVS patients complained of snoring, morning headaches and excessive daytime sleepiness compared to OSA alone (median Epworth Sleepiness Scale score: 9 [interquartile range (IQR) 6-13] versus 10 (IQR 6-13), respectively; P <0.02). Similarly, a lower proportion of OVS patients (35.6% versus 39.4%, respectively; P <0.01) experienced sleepiness while driving. In contrast, 63.5% of the OVS population experienced nocturia compared to 58.0% of the OSA population (P<0.01). Apnea hypopnea index (36 [25; 52] vs 33.1 [23.3; 50]), oxygen desaturation index (28 [15; 48] vs 25.2 [14; 45]) and mean nocturnal SaO2 (92 [90; 93.8] vs 93 [91.3; 94]) were significantly more altered in the OVS group. Associated COPD had no effect on the prevalence of hypertension and stroke. After controlling for main confounders, COPD severity was associated in a dose-response relationship with a higher prevalence of coronary heart disease, heart failure and peripheral arteriopathy. CONCLUSIONS: In adults with moderate-to-severe OSA, OVS was minimally symptomatic, but exhibited higher odds for prevalent coronary heart disease, heart failure and peripheral arteriopathy.
BACKGROUND: More advanced knowledge is needed on how COPD alters the clinical presentation of obstructive sleep apnea (OSA) and how the association of both diseases, known as 'overlap syndrome' (OVS), impacts on cardiovascular health. OBJECTIVE: To investigate differences between patients with OVS and those with moderate-to-severe OSA alone. METHODS: A cross-sectional study conducted in the French National Sleep Apnea Registry between January 1997 and January 2017. Univariable and multivariable logistic regression models were used to compare OVS versus OSA alone on symptoms and cardiovascular health. RESULTS: 46,786 patients had moderate-to-severe OSA. Valid spirometry was available for 16,466 patients: 14,368 (87%) had moderate-to-severe OSA alone and 2098 (13%) had OVS. A lower proportion of OVS patients complained of snoring, morning headaches and excessive daytime sleepiness compared to OSA alone (median Epworth Sleepiness Scale score: 9 [interquartile range (IQR) 6-13] versus 10 (IQR 6-13), respectively; P <0.02). Similarly, a lower proportion of OVS patients (35.6% versus 39.4%, respectively; P <0.01) experienced sleepiness while driving. In contrast, 63.5% of the OVS population experienced nocturia compared to 58.0% of the OSA population (P<0.01). Apnea hypopnea index (36 [25; 52] vs 33.1 [23.3; 50]), oxygen desaturation index (28 [15; 48] vs 25.2 [14; 45]) and mean nocturnal SaO2 (92 [90; 93.8] vs 93 [91.3; 94]) were significantly more altered in the OVS group. Associated COPD had no effect on the prevalence of hypertension and stroke. After controlling for main confounders, COPD severity was associated in a dose-response relationship with a higher prevalence of coronary heart disease, heart failure and peripheral arteriopathy. CONCLUSIONS: In adults with moderate-to-severe OSA, OVS was minimally symptomatic, but exhibited higher odds for prevalent coronary heart disease, heart failure and peripheral arteriopathy.
Authors: Marta Marin-Oto; Luis M Seijo; Miguel Divo; Gorka Bastarrika; Ana Ezponda; Marta Calvo; Javier J Zulueta; Guillermo Gallardo; Elena Cabezas; German Peces-Barba; Maria T Pérez-Warnisher; Jose M Marín; Bartolomé R Celli; Ciro Casanova; Juan P De-Torres Journal: J Clin Med Date: 2021-01-30 Impact factor: 4.241
Authors: Jean-Louis Pépin; Sébastien Bailly; Pierre Rinder; Dan Adler; Daniel Szeftel; Atul Malhotra; Peter A Cistulli; Adam Benjafield; Florent Lavergne; Anne Josseran; Renaud Tamisier; Pierre Hornus Journal: J Clin Med Date: 2021-03-01 Impact factor: 4.241