Study of assessment of improvement in sleep apnea with continuous positive airway pressure trial in patients of obstructive airway diseases with obstructive sleep apnea

Abstract

Background & Objectives: Sleep disordered breathing, mainly obstructive sleep apnea (OSA) and obstructive airway diseases (OADs) are among the most common pulmonary diseases. Patients with both disorders, has more severe nocturnal hypoxia than either disease alone. This study is an attempt to explore risk factors and effect of positive airway pressure therapy on severity of sleep apnea in these (overlap syndrome) patients. Methods: This prospective, observational study was conducted in sleep laboratory of the department of pulmonary medicine over a period of 18 months. Patients with obstructive airway diseases diagnosed by spirometry; later on underwent polysomnography to confirm diagnosis of OSA. These patients were subjected to one full night attended nasal continuous positive airway pressure (auto-CPAP) therapy to determine its effect on OSA severity. Results: Hundred patients of obstructive airway diseases were included in the study after written and informed consent. These patients underwent polysomnography for presence of OSA. Age more than 45 years, male sex, obesity, smoking, nasal polyps were the risk factors associated with development of OSA in patients with COPD and bronchial asthma. 26 patients were diagnosed as having OSA. Total 19 patients in whom positive airway pressure therapy (CPAP) was indicated, were given one full night attended auto-CPAP. Before CPAP application, mean apnea-hypopnea index (AHI) was 33.12 and after application of auto-CPAP, it decreased upto 5.95. Conclusions: Polysomnography should be done in patients of overlap syndrome to diagnose OSA. Auto-CPAP therapy was found to be well tolerated amongst these patients and it improves OSA by decreasing the AHI.

Keywords

• overlap syndrome
• polysomnography
• positive airway pressure
• sleep disorders