Chronic obstructive pulmonary disease - obstructive sleep apnea overlap syndrome choosing the right positive pressure therapy

Patients with chronic obstructive pulmonary disease (COPD) -obstructive sleep apnea (OSA) overlap syndrome have worse outcomes than patients with either COPD or OSA alone. Positive pressure therapy (continuous positive airway pressure -CPAP or noninvasive ventilation -NIV) is still a matter of debate. The aim of the study is to identify clinical (symptoms, changes in physical examination) and paraclinical (spirometry, arterial blood gases and respiratory events during sleep) parameters that could orientate the phys ician towards choosing a certain type of positive pressure therapy in p atients with COPD-OSA overlap syndrome. Material and method: 84 patients with overlap syndrome were included. A very thorough anamnesis, physical examination, blood samples, spirometry and ventilatory polygraphy was performed in all patients. Results: Most patients had severe sleep apnea with an average of 38 events per hour of sleep, and moderate COPD -stage II GOLD. The positive therapy used was mainly CPAP (57%), and the preferred mask was oronasal. Conclusions: Patients with overlap syndrome appear to prefer CPAP as positive therapy treatment and oronasal mask as interface. However, we could not establish any co rrelation between any clinical, functional or ventilatory polygraphy parameters that could e xplain the choice of one or another type of positive pressure devices.