Prognosis of OSA-COPD overlap syndrome: A matter of concern

Abstract

The impact of obstructive sleep apnea (OSA)-chronic obstructive pulmonary disease (COPD) overlap syndrome (OVS) should not be ignored. Increased upper airway resistance, systemic inflammatory response, and increased sympathetic nerve activity contributed to the adverse clinical outcomes in overlapping patients. Compared with COPD or OSA alone, those with OVS have more severe daytime hypoxemia and hypercapnia, leading to increased frequency and severity of COPD exacerbations. Consequently, patients with OVS experience increased rates of hospitalization and all-cause mortality, alongside a markedly elevated risk of cardiovascular events. Continuous positive airway pressure (CPAP) as a treatment can improve oxygenation and lung function in patients with OVS and reduce the risk of COPD exacerbation and cardiovascular death. However, individual differences in treatment effectiveness suggest the need for individualized treatment regiments and compliance monitoring. In addition, the current research evidence on OVS is insufficient, and more large-sample, multicenter studies are needed to evaluate disease prognosis in patients with different phenotypes and establish uniform evaluation and treatment guidelines to optimize the clinical management of patients with OVS.

Keywords

cardiovascular events / chronic obstructive pulmonary disease / mortality / obstructive sleep apnea / overlap syndrome

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