Nattusami Loganathan, Hadda Vijay, Khilnani Gopi C, Madan Karan, Mittal Saurabh, Tiwari Pawan, Mohan Anant, Khan Maroof Ahmad, Guleria Randeep
Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Lung India. 2021 Jan-Feb;38(1):12-17. doi: 10.4103/lungindia.lungindia_169_20.
Chronic obstructive pulmonary disease (COPD) is a common airway disease that is frequently associated with comorbidities. In this study, we assessed the co-existence of obstructive sleep apnea (OSA) among patients with stable COPD.
This cross-sectional study included patients with stable COPD who were screened with Epworth's Sleepiness Scale (ESS). Those with ESS score of >10 were subjected to in-lab polysomnography (PSG). PSG was manually analyzed and reported. Patients with apnea-hypopnea index of >5/h were diagnosed as OSA.
This study included 301 patients (78.1% male, 76.4% smokers, age 59.6 ± 10 years) with stable COPD. ESS score of >10 was observed in 47 (15.6%) patients. Among patients with ESS score of >10, OSA was observed in 34 (72.3%) patients. The overall prevalence of OSA among patients with COPD was 10.9%. Patients with co-existing OSA were older and had thicker neck and higher body mass index (BMI) as compared to COPD alone. In addition, patients with associated OSA had worse health-related quality of life (QOL) as shown by higher St. George's Respiratory Questionnaire score (42.42 ± 7.22 vs. 25.22 ± 8.66;P < 0.001).
Co-existing OSA is common among patients with COPD and has a significant adverse effect on the QOL. Among COPD patients, older age, thick neck, and high BMI may predict co-existing OSA and require PSG for the confirmation.
慢性阻塞性肺疾病（COPD）是一种常见的气道疾病，常伴有合并症。在本研究中，我们评估了稳定期COPD患者中阻塞性睡眠呼吸暂停（OSA）的共存情况。
这项横断面研究纳入了使用爱泼华嗜睡量表（ESS）进行筛查的稳定期COPD患者。ESS评分>10分的患者接受实验室多导睡眠图（PSG）检查。PSG由人工分析并报告。呼吸暂停低通气指数>5次/小时的患者被诊断为OSA。
本研究纳入了301例稳定期COPD患者（男性占78.1%，吸烟者占76.4%，年龄59.6±10岁）。47例（15.6%）患者的ESS评分>10分。在ESS评分>10分的患者中，34例（72.3%）患者存在OSA。COPD患者中OSA的总体患病率为10.9%。与单纯COPD患者相比，合并OSA的患者年龄更大，颈部更粗，体重指数（BMI）更高。此外，合并OSA的患者健康相关生活质量（QOL）更差，圣乔治呼吸问卷评分更高（42.42±7.22对25.22±8.66；P<0.001）。
合并OSA在COPD患者中很常见，对QOL有显著不良影响。在COPD患者中，年龄较大、颈部粗壮和BMI较高可能预示合并OSA，需要进行PSG检查以确诊。
