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Obstructive sleep apnea (OSA) is a serious sleep disorder that occurs in approximately 10 to 15% of all patients with COPD. When OSA and COPD coexist, they are commonly coined as “overlap syndrome.” Sleep apnea is generally caused by an obstruction of the upper airway during sleep (OSA), but it can also be caused by a failure of the brain to initiate a breath (central sleep apnea). Left untreated, people with both conditions have an increased risk of death and hospitalizations due to COPD exacerbation.1
People with sleep apnea repeatedly stop (or nearly stop) breathing during sleep. These episodes, which can last 10 seconds or more, cause oxygen levels in the blood to drop which may lead to additional serious health consequences.
Symptoms of sleep apnea include:1
In general, people with untreated sleep apnea have more automobile accidents and a higher level of family and social discord compared to people who don’t have OSA. They also frequently suffer from a decreased quality of life.
Smoking and the use of alcohol, sedatives and/or tranquilizers are important risk factors for OSA. Others include:
People with overlap syndrome have a higher degree of hypoxemia (low blood oxygen levels) and hypercapnia (high carbon dioxide levels) than people who have COPD, alone. Overlap syndrome also contributes to a higher prevalence of pulmonary hypertension, right-sided heart failure (cor pulmonale), and overall ill health. In addition, OSA has been linked to heart disease, general high blood pressure, irregular heart rhythms, heart attack, and stroke.
The simplest treatment for OSA in cases of obesity is weight loss. For many people, however, weight loss is not an attainable, long-term goal. Consequentially, continuous positive airway pressure therapy (CPAP) is the most common treatment for OSA. Other treatment options include dental devices such as tongue-retaining devices or bite guards, or corrective surgery if your OSA is severe and you’re unable to tolerate CPAP.
CPAP therapy is delivered by a machine that’s designed to increase the air pressure in your throat when you take a breath in, thus preventing your airway from collapsing while you sleep. It can be used with a mask that covers your nose and mouth, a mask that covers only your nose, or nasal prongs.
CPAP used along with supplemental oxygen has the following benefits for people with overlap syndrome who experience a decrease in oxygen saturation when they sleep:
For people who don’t experience a drop in oxygen while they sleep but are diagnosed with OSA, CPAP can be used without supplemental oxygen.
Do you snore loudly? Does your bedroom partner complain about your snoring? If so, you may want to rule out sleep apnea as the root of your sleep problems. Other questions to ask yourself include:
If you snore excessively and have any of the problems listed above, you should be evaluated for sleep apnea. Because early diagnosis and treatment are important for avoiding serious complications associated with overlap syndrome, consider making an appointment with your health care provider as soon as possible to discuss a sleep evaluation.
 Xavier Soler, MD, PhD, Assistant Professor of Medicine, Pulmonary and Critical Care Division, University of California San Diego. Sleep Apnea and COPD: What Patients Should Know. COPD Foundation. July 25, 2011.
 Mayo Clinic. Sleep Apnea Risk Factors. July 24, 2012.
 WebMD. Continuous Positive Airway Pressure (CPAP) for Obstructive Sleep Apnea. Updated January 14, 2014.
 Carlos Zamarrón Sanz, Carlos Rábade Castedo, Ester Zamarrón de Lucas, Emilio Morete Aracay and Félix del Campo Matias. Sleep and its Disorders Affect Society. September 24, 2014,
 Pronzato C. Chronic obstructive pulmonary disease and obstructive sleep apnea: Association, consequences and treatment. Monaldi Arch Chest Dis. 2010 Dec;73(4):155-61.