Pronzato C
U.O. di Pneumologia Riabilitativa, Istituto Scientifico di Montescano IRCCS, Fondazione Salvatore Maugeri, Montescano (Pavia), Italy.
Monaldi Arch Chest Dis. 2010 Dec;73(4):155-61. doi: 10.4081/monaldi.2010.285.
Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are two diseases that often co-exist within an individual. This co-existence, known as overlap syndrome (OS), is the result of chance rather than a pathophysiological linkage and epidemiological studies indicate a prevalence of 1% in adult males. Patients vith OS have a more important sleep-related O2 desaturation than COPD patients with the same degree of bronchial obstruction and show an increased risk of developing hypercapnic respiratory failure and pulmonary hypertension when compared with patients affected by only one of he diseases. COPD and OSAS are independent risk factors for cardiovascular events and their co-existence in OS probably increases this risk. Evidence of systemic inflammation in COPD and sleep apnea and consequentely OS, is interesting because it may contribute to the pathogenesis of cardiovascular diseases. Treatment consists of continuous positive airway pressure (CPAP) or non-invasive positive pressure ventilation (NIPPV), with or without associated O2, for correction of the upper airway obstructive episodes and hypoxemia during sleep.
阻塞性睡眠呼吸暂停综合征（OSAS）和慢性阻塞性肺疾病（COPD）是两种常共存于同一个体的疾病。这种共存情况，即重叠综合征（OS），是偶然发生的结果，而非病理生理联系，流行病学研究表明成年男性中的患病率为1%。与具有相同程度支气管阻塞的COPD患者相比，OS患者存在更严重的与睡眠相关的氧饱和度下降，并且与仅患其中一种疾病的患者相比，发生高碳酸血症性呼吸衰竭和肺动脉高压的风险增加。COPD和OSAS是心血管事件的独立危险因素，它们在OS中共存可能会增加这种风险。COPD和睡眠呼吸暂停以及由此导致的OS中存在全身炎症的证据很有意思，因为它可能有助于心血管疾病的发病机制。治疗包括持续气道正压通气（CPAP）或无创正压通气（NIPPV），可联合或不联合吸氧，以纠正睡眠期间的上气道阻塞发作和低氧血症。
