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Overlaps between obstructive sleep apnoea and other respiratory diseases, including COPD, asthma and interstitial lung disease

Izolde Bouloukaki, Michail Fanaridis, Dries Testelmans, Athanasia Pataka, Sophia Schiza
Breathe 2022 18: 220073; DOI: 10.1183/20734735.0073-2022
Izolde Bouloukaki
1Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
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Michail Fanaridis
1Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
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  • ORCID record for Michail Fanaridis
Dries Testelmans
2Department of Pneumology, UZ Leuven, Leuven, Belgium
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Athanasia Pataka
3Respiratory Failure Unit, G. Papanikolaou Hospital Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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  • ORCID record for Athanasia Pataka
Sophia Schiza
1Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
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  • For correspondence: schiza@med.uoc.gr
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  • FIGURE 1
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    FIGURE 1

    The overlap syndrome as a synergistic relationship between coexisting respiratory disease and obstructive sleep apnoea (OSA). ILD: interstitial lung disease.

  • FIGURE 2
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    FIGURE 2

    Protective and promoting factors for overlap syndrome development. REM: rapid eye movement; OSA: obstructive sleep apnoea.

  • FIGURE 3
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    FIGURE 3

    Pathophysiological interactions between COPD and obstructive sleep apnoea (OSA) predisposing to cardiovascular disease.

  • FIGURE 4
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    FIGURE 4

    Proposed pathophysiological relationships between obstructive sleep apnoea (OSA) and idiopathic pulmonary fibrosis (IPF). REM: rapid eye movement; GORD: gastro-oesophageal reflux disease.

Tables

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  • TABLE 1

    Clinical characteristics and parameters resulting in high clinical suspicion for obstructive sleep apnoea (OSA) in patients with COPD

    Symptoms compatible with OSA, such as snoring, witnessed apnoeas, unrefreshed sleep, daytime sleepiness and nocturia
    Obesity as measured by:
     Body mass index (>30 kg·m−2 in males and >35 kg·m−2 in females)
     Neck circumference (>43 cm in males and >41 cm in females)
    Deranged blood gases
     Persistent daytime hypoxaemia
     Hypercapnia
    Signs of pulmonary hypertension or right heart failure, such as peripheral oedema
    Polycythaemia
    Use of opioids and/or hypnotic medications
    Comorbidities such as:
     Resistant hypertension
     Atrial fibrillation
     Heart failure
     Type 2 diabetes
     Stroke
     End-stage renal disease
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Overlaps between obstructive sleep apnoea and other respiratory diseases, including COPD, asthma and interstitial lung disease
Izolde Bouloukaki, Michail Fanaridis, Dries Testelmans, Athanasia Pataka, Sophia Schiza
Breathe Sep 2022, 18 (3) 220073; DOI: 10.1183/20734735.0073-2022

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Overlaps between obstructive sleep apnoea and other respiratory diseases, including COPD, asthma and interstitial lung disease
Izolde Bouloukaki, Michail Fanaridis, Dries Testelmans, Athanasia Pataka, Sophia Schiza
Breathe Sep 2022, 18 (3) 220073; DOI: 10.1183/20734735.0073-2022
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