Sleep Apnea With COPD Boosts Mortality (without CPAP)

[mars]

Hi Everybody

The latest news from Reuters Health -

Sleep Apnea With COPD Boosts Mortality

NEW YORK (Reuters Health) Apr 30 - In patients with chronic obstructive pulmonary disease (COPD), obstructive sleep apnea increases the risk of hospitalization and death - but not if they use continuous positive airway pressure (CPAP), according to a new study.

"Patients with COPD should be screened for obstructive sleep apnea because if present, its treatment is associated with improved outcomes," said lead author Dr. Jose M. Marin of Hospital Universitario Miguel Servet, Zaragoza, and colleagues.

The researchers studied 228 patients with COPD and sleep apnea (the so-called "overlap syndrome") who used CPAP, another 223 with overlap syndrome not using CPAP, and 210 COPD patients without obstructive sleep apnea.

After a median follow-up of 9.4 years, there were 213 all-cause deaths. Among all patients with the overlap syndrome, all-cause and cardiovascular mortality were lower with CPAP than without it (1.75 vs 5.70 events per 100 person-years).

The cardiovascular mortality rate was 7.5% in the CPAP patients and 14.5% in the non-CPAP group, according to the April 8th online report in the American Journal of Respiratory and Critical Care Medicine.

After adjustment for factors including age and body mass index, patients with CPAP-untreated overlap syndrome had a relative risk for mortality of 1.79 compared to patients with COPD alone, and a 1.70 relative risk for exacerbation-associated hospitalization.

With CPAP treatment, however, outcomes in the overlap syndrome patients were similar to those in patients with COPD alone.

Among factors that might contribute to their findings, the authors say, is that overlap patients with mild to moderate COPD have marked daytime hypoxemia and more frequent pulmonary hypertension than patients with COPD alone.

American Journal of Respiratory and Critical Care Medicine 2010.

cheers

Mars

PS The underlining in the article is mine.

[DreamStalker]

I don't think it matters whether one has COPD or not.

Not using CPAP to treat one's sleep apnea "boosts" pre-mature mortality ... period.

[wil]

Isn't this one of those "Duh!" studies?

[echo]

Agreed, sort of a Duh! conclusion. The most redeeming part of the article imho is

"Patients with COPD should be screened for obstructive sleep apnea because if present, its treatment is associated with improved outcomes," said lead author Dr. Jose M. Marin of Hospital Universitario Miguel Servet, Zaragoza, and colleagues.

Any co-screening strategy that catches potential OSA sufferers is good. e.g. colonoscopy, dentist, etc...

[patdart]

Agreed, sort of a Duh! conclusion. The most redeeming part of the article imho is

"Patients with COPD should be screened for obstructive sleep apnea because if present, its treatment is associated with improved outcomes," said lead author Dr. Jose M. Marin of Hospital Universitario Miguel Servet, Zaragoza, and colleagues.

Any co-screening strategy that catches potential OSA sufferers is good. e.g. colonoscopy, dentist, etc...

As someone with diagnosed COPD, I believe this is an important finding. I wasn't studied until my hematologist ordered it for another, unrelated, condition. I wish my Pulmonologist had suggested it earlier. It may be a 'Duh' thing, but could save lives.