Symptomatic response to CPAP in obstructive sleep apnea versus COPD- obstructive sleep apnea overlap syndrome: Insights from a large national registry

• Published in: PloS one 2021-08, Vol.16 (8), p.e0256230-e0256230
• Main Authors: Adler, Dan, Bailly, Sébastien, Soccal, Paola Marina, Janssens, Jean-Paul, Sapène, Marc, Grillet, Yves, Stach, Bruno, Tamisier, Renaud, Pépin, Jean-Louis
• Format: Article
• Language: English
• Subjects: Apnea; Biology and Life Sciences; Body mass; Body mass index; Body size; Care and treatment; Chronic obstructive pulmonary disease; Clinical trials; Comparative analysis; Complications and side effects; Continuous positive airway pressure; Continuous Positive Airway Pressure - methods; Disease; Disorders of Excessive Somnolence - physiopathology; Disorders of Excessive Somnolence - prevention & control; Dyspnea; Fatigue - physiopathology; Fatigue - prevention & control; Female; France; Funding; Health services; Hospitals; Humans; Laboratories; Life Sciences; Lung diseases, Obstructive; Male; Medicine; Medicine and Health Sciences; Middle Aged; Morning; Normalizing; Observational studies; Patient Compliance; Patient outcomes; Patients; Prospective Studies; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Pulmonology; Registries; Respiration; Respiratory diseases; Severity of Illness Index; Sleep; Sleep and wakefulness; Sleep apnea; Sleep apnea syndromes; Sleep Apnea Syndromes - physiopathology; Sleep Apnea Syndromes - therapy; Sleep disorders; Sleepiness; Spirometry; Therapy; Thorax; Variables
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0256230

The symptomatic response to continuous positive airway pressure (CPAP) therapy in COPD-obstructive sleep apnea overlap syndrome (OVS) compared to OSA syndrome (OSA) alone has not been well studied so far. The aim of this study is to explore main differences in the clinical response to CPAP treatment in OVS compared to OSA alone. Using prospective data from the French National Sleep Apnea Registry, we conducted an observational study among 6320 patients with moderate-to-severe OSA, available spirometry, and at least one follow-up visit under CPAP therapy. CPAP efficacy measured on the residual apnea-hypopnea index and median adherence were similar between OVS and OSA patients. In both groups, the overall burden of symptoms related to sleep apnea improved with CPAP treatment. In a multivariable model adjusted for age, gender, body mass index, adherence to treatment and residual apnea-hypopnea index, OVS was associated with higher odds for persistent morning headaches (OR: 1.37 [95% CI; 1.04; 1.79]; P = 0.02), morning tiredness (OR: 1.33 [95% CI: 1.12; 1.59]; P