Abstract

Copyright © 2015 by the American Thoracic Society. Rationale: When obstructive sleep apnea and chronic obstructive pulmonary disease coexist in the so-called "overlap" syndrome,a high risk formortalityandmorbidity hasbeenreported.There is controversy about the prevalence of OSA in people affected by COPD. Objectives: The purpose of this study was to investigate objective meaures of sleep-disordered breathing in patients with moderate to severe COPD to test the hypothesis that COPD is associated with an increased prevalence of OSA. Methods: Fifty-four patients with moderate to severe COPD were enrolled prospectively. Twenty patients were on supplemental oxygen at baseline. Exercise tolerance; questionnaires related to symptoms, sleep, and quality of life; and home polysomnography were obtained. Measurements and Main Results: Forty-four patients had full polysomnography suitable for analysis. OSA was present in 29 subjects. Sleep efficiency was poor in 45% of subjects. Conclusions: OSA is highly prevalent in patients with moderate to severe COPD referred to pulmonary rehabilitation. Sleep quality is also poor among this selected group. These patients have greaterthan- expected sleep-disordered breathing, which could be an important contributory factor to morbidity and mortality. Pulmonary rehabilitation programs should consider including a sleep assessment in patients with moderate to severe COPD and interventions when indicated to help reduce the impact of OSA in COPD.