COPD (chronic obstructive pulmonary disease)-OSAHS (obstructive sleep apnoea/hypopnoea syndrome) overlap syndrome
COPD-OSAHS overlap syndrome occurs in people who have both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea/hypopnoea syndrome (OSAHS). The combined effect of these conditions on ventilatory load, gas exchange, comorbidities and quality of life is greater than either condition alone.
Initial assessment for COPD-OSAHS overlap syndrome
When to suspect COPD-OSAHS overlap syndrome
Take a sleep history and assess people for COPD-OSAHS overlap syndrome if they have confirmed COPD with:
- features of OSAHS When to suspect OSAHS Be aware that there is a higher prevalence of OSAHS in people with any of the following conditions:
- take a sleep history and assess people for OSAHS if they have 2 or more of the following features:
- snoring
- witnessed apnoeas
- unrefreshing sleep
- waking headaches
- unexplained excessive sleepiness, tiredness or fatigue
- nocturia (waking from sleep to urinate)
- choking during sleep
- sleep fragmentation or insomnia
- cognitive dysfunction or memory impairment
- obesity or overweight
- obesity or overweight in pregnancy
- treatment-resistant hypertension
- type 2 diabetes
- cardiac arrythmia, particularly atrial fibrillation
- stroke or transient ischaemic attack
- chronic heart failure
- moderate or severe asthma
- polycystic ovary syndrome
- Down's syndrome
- non-arteritic anterior ischaemic optic neuropathy (sudden loss of vision in 1 eye due to decreased blood flow to the optic nerve)
- hypothyroidism
- acromegaly
- or
- features of nocturnal hypoventilation such as:
- waking headaches
- peripheral oedema
- hypoxaemia (arterial oxygen saturation less than 94% on air)
- unexplained polycythaemia
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