Nocturnal nasal high-flow oxygen therapy in elderly patients with concomitant chronic obstructive pulmonary disease and obstructive sleep apnea

Purpose The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) is known as “overlap syndrome” (OS). Patients with OS are usually older than patients with OSA alone, suffer from more profound oxygen desaturation during the obstructive events often accompanie...

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Bibliographic Details
Published in:Sleep & breathing 2023-06, Vol.27 (3), p.1049-1055
Main Authors: Spicuzza, Lucia, Sambataro, Gianluca, Schisano, Matteo, Ielo, Giuseppe, Mancuso, Salvatore, Vancheri, Carlo
Format: Article
Language:English
Subjects:
Aged
Apnea
Chronic obstructive pulmonary disease
Coexistence
Dentistry
Humans
Hypoventilation
Internal Medicine
Lung
Lung diseases
Medicine
Medicine & Public Health
Neurology
Obstructive lung disease
Older people
Otorhinolaryngology
Oxygen
Oxygen Inhalation Therapy
Oxygen therapy
Pediatrics
Pneumology/Respiratory System
Pulmonary Disease, Chronic Obstructive - complications
Respiratory failure
Sleep apnea
Sleep Apnea, Obstructive
Sleep Breathing Physiology and Disorders • Original
Sleep Breathing Physiology and Disorders • Original Article
Sleep disorders
Syndrome
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Summary:Purpose The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) is known as “overlap syndrome” (OS). Patients with OS are usually older than patients with OSA alone, suffer from more profound oxygen desaturation during the obstructive events often accompanied by sustained nocturnal hypoventilation. Although oxygen-enriched positive airway pressure (PAP) is the treatment of choice in these patients, this therapy is often poorly tolerated particularly by the elderly. The aim of this study was to assess the usefulness of nocturnal oxygen therapy via nasal high flow (NHF-OT) as a possible alternative to PAP in patients with OS. Methods Patients > 65 years old with OS and nocturnal respiratory failure (time spent below SaO 2 90% (T90) > 30%) had cardio-respiratory monitoring performed at baseline, during NHF-OT, or during conventional oxygen therapy (COT). Results A total of 40 patients were enrolled in the study. NHF-OT significantly reduced the apnea–hypopnea index (AHI) in all patients compared to baseline and COT. The mean basal AHI was 25.4 ± 8.6. During COT and NHF-OT, the AHI was 19.4 ± 7 and 5.4 ± 4.6, respectively ( P  
ISSN:1520-9512
1522-1709
1522-1709
DOI:10.1007/s11325-022-02702-2