Clinical Characteristics Of AECOPD Combined With OSA Overlap Syndrome

Objective:1.To evaluate the prevalence of obstructive sleep apnea?OSA?in a cohort of AECOPD patients.2.To explore OVS risk factors and its association with comorbidities in the COPD patients.Methods:This study was a prospective clinical observation study.Individuals with AECOPD were recruited from emergency department.After signing informed consent,information on age,gender,body mass index?BMI?,smoking index,arterial blood pressure,acute exacerbations of COPD in the past year,mMRC,chronic obstructive pulmonary disease assessment test?CAT?,sleep apnea clinical score?SACS?,Pittsburgh sleep quality index?PSQI?,modified Epworth sleepiness scale?mESS?were collected.BNP,arterial blood gas,blood routine information on coagulation factors were tested and a spirometry was performed.Participants underwent a nocturnal polygraphy using the portable device at hospital.An apnea-hypopnea index?AHI??5 per hour was considered to indicate OSA.According to whether OSA was combined,it was divided into COPD group and OVS group;in OVS group,it was divided into three groups according to AHI:mild group?5?AHI<15?,moderate group?15?AHI<30?and severe group?AHI?30?.Results:A total of 112 AECOPD patients were recruited,except 3 patients who refused or could not tolerate the sleep monitoring,109 patients were enrolled.There were 62 patients?57%?in the COPD group and 47 patients?43%?in the OVS group.In the COPD group,there were 51 males and 11 females,aged 70.4±8.8 years old mean smoking index is 43 years?range 9-56?.In the OVS group,there were 41 males and 6 females,aged 70.4±8.9 years old,the mean smoking index is 40 years?range20-53?.There were no significant differences in age,gender or smoking index between the two groups.The BMI of the COPD group was 18.7 kg/m²?range17.3-21.0?,and the BMI of the OVS group was 23.7 kg/m²?range 20.8-27.7?.The difference between the two groups was significant?P<0.01?.The parameters of hypertension,snoring,neck circumference and BNP were significant?P<0.01?,and the OVS group was higher than the COPD group.There was also a significant difference in the number of hospitalizations within one year?P<0.05?,but the OVS group was lower than the COPD group.There was no significant difference in PH,PaO₂ and PaCO₂ between the COPD group and the OVS group.In the OVS group,13cases were mild,19 cases were moderate,and 15 cases were severe.There was no statistical difference between the three groups.Binary logistic regression analysis showed that snoring,hypertension,and neck circumference were risk factors for COPD combined with OSA?P=0.024,<0.01,<0.01?.There was no significant difference in erythrocyte and coagulation factor between the COPD group and the OS group.Conclusions:The prevalence of AECOPD combined with OSA is 43%.BMI and neck circumference seem to be predictors of the OVS.Snoring and hypertension are both risk factors for OVS.FIB is elevated in both COPD and OVS patients,and the specific mechanism needs further study.The SACS screening questionnaire may be helpful in identifying appropriate patients for further night sleep studies.