Multiple Symptoms of Drowsiness and Snoring in Patients with COPD

For patients with chronic obstructive pulmonary disease, sleep duration and sleep quality are impaired to varying degrees, and many patients will have significant nocturnal hypercapnia and hypoxemia, and if sleep apnea (OSA) is superimposed on these symptoms, then the patient's nighttime hypoxia will increase significantly. The medical term for this group is "overlap syndrome".

In general, people with obstructive sleep apnea (OSA) only need to be treated with a single level ventilator at night to significantly relieve their symptoms. However, this overlap syndrome of OSA + chronic obstructive pulmonary disease is more complicated, how to choose a ventilator is better?
Many patients have significant nocturnal hypercapnia and hypoxemia, and if sleep apnea (OSA) is added to these symptoms, the patient's nocturnal hypoxia will be significantly increased, and there is a medical term for this group of people called "overlap syndrome The medical term for this group is "overlap syndrome".

In general, people with obstructive sleep apnea (OSA) only need to be treated with a single level ventilator at night to significantly relieve their symptoms. However, this overlapping syndrome of OSA + chronic obstructive lung is more complicated, how to choose a better ventilator?

How to determine whether a patient with chronic obstructive pulmonary disease is a combination of sleep breathing disorders?

1.Daytime sleepiness and snoring

When a patient with chronic obstructive pulmonary disease is combined with daytime sleepiness, obesity, small jaw and snoring, especially when sleep apnea is found by relatives, the possibility of OSA should be considered.

2.No obvious signs of daytime hypoxia but combined with pulmonary hypertension and pulmonary heart disease, lower limb edema

Since most of the patients with chronic obstructive pulmonary disease in China have anatomical narrowing of the upper airway, they may combine OSA symptoms even without obesity manifestations; there is another category of patients with chronic obstructive pulmonary disease without obesity manifestations, who also have or potentially have anatomical narrowing of the upper airway due to deviated nasal septum, long-term rhinitis, congenital hypertrophy of tonsils, etc., and may combine OSA.

Therefore, the possibility of overlap syndrome should be considered in patients with chronic obstructive pulmonary disease who do not show obvious hypoxia during daytime but have combined pulmonary hypertension and pulmonary heart disease and lower extremity edema, and the examination related to sleep breathing disease should be performed.

3. Nocturnal hypoxemia
Patients with chronic obstructive pulmonary disease (COPD) may develop nocturnal hypoxemia due to decreased central respiratory drive during sleep even if they are not combined with OSA. Therefore, it is recommended that patients with COPD should undergo simplified or comprehensive sleep polysomnography monitoring - polysomnography (PSG) - whenever possible.

4. Clinical manifestations of sleep apnea in COPD patients
Pulmonary function tests should be performed in patients with OSA, especially those with a long history of smoking, cough, sputum, dyspnea and limitation of movement, and the diagnosis of slow-onset lung should be considered based on the patient's symptoms and signs, combined with X-ray chest radiographs and pulmonary function indices.