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Title: Current evidence on prevalence and clinical outcomes of co-morbid obstructive sleep apnea and chronic obstructive pulmonary disease: a systematic review.
Austin Authors: Shawona, Shajedur R;Perret, Jennifer L ;Senaratna, Chamara V;Lodge, Caroline;Hamilton, Garun S;Dharmage, Shyamali C
Affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Department of Public Health Sciences, Karolinska Institutet, Tomtebodavagen, Stockholm, Sweden
Department of Community Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
Department of Lung and Sleep Medicine at Monash Health, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
Allergy and Lung Health Unit, Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, Victoria, Australia
Issue Date: Apr-2017 2016-03-02
Publication information: Sleep Medicine Reviews 2017; 32: 58-68
Abstract: The objective of this systematic review is to synthesize the evidence on prevalence, polysomnographic findings and clinical outcomes of co-morbid obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) - known as the "overlap syndrome". We systematically searched PubMed on 1 December 2015 using appropriate medical subject headings (MeSH) and text words to capture prevalence studies and comparative studies of any observational design examining the clinical outcomes in patients with co-existent COPD and OSA. We reviewed 591 articles and included 27 in the final review. In total, 21 observational studies (n = 29,341 participants) provided prevalence estimates. Overlap syndrome is not common in the general and hospital population (range: 1.0-3.6%), but is highly prevalent in patients diagnosed with either obstructive sleep apnea (range: 7.6-55.7%) or COPD (range: 2.9-65.9%). Overlap syndrome patients have been shown to have greater nocturnal oxygen desaturation (NOD) (i.e., reduced mean peripheral capillary oxygen saturation (SpO2) and increased sleep time spent with SpO2 < 90% (T90)) and worse sleep quality than patients with only OSA. It is associated with more frequent cardiovascular morbidity, poorer quality of life (QoL), more frequent COPD exacerbation and increased medical costs. This systematic review on overlap syndrome highlights the limitations and knowledge gaps of its prevalence, etiology and underlying pathophysiologic mechanisms related to increased morbidity and mortality.
DOI: 10.1016/j.smrv.2016.02.007
Journal: Sleep Medicine Reviews
PubMed URL:
Type: Journal Article
Subjects: Chronic obstructive pulmonary disease (COPD)
Clinical outcome
Nocturnal oxygen desaturation (NOD)
Obstructive sleep apnea (OSA)
Overlap syndrome
Type of Clinical Study or Trial: Reviews/Systematic Reviews
Appears in Collections:Journal articles

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