COPD (chronic obstructive pulmonary disease) - OSAHS (obstructive sleep apnoea/hypopnoea syndrome) overlap syndrome

Last edited 09/2021 and last reviewed 10/2021

COPD (chronic obstructive pulmonary disease)-OSAHS (obstructive sleep apnoea/hypopnoea syndrome) overlap syndrome

COPD-OSAHS overlap syndrome occurs in people who have both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea/hypopnoea syndrome (OSAHS). The combined effect of these conditions on ventilatory load, gas exchange, comorbidities and quality of life is greater than either condition alone.

Initial assessment for COPD-OSAHS overlap syndrome


When to suspect COPD-OSAHS overlap syndrome

Take a sleep history and assess people for COPD-OSAHS overlap syndrome if they have confirmed COPD with:

  • features of OSAHS

    When to suspect OSAHS

    • take a sleep history and assess people for OSAHS if they have 2 or more of the following features:
      • snoring
      • witnessed apnoeas
      • unrefreshing sleep
      • waking headaches
      • unexplained excessive sleepiness, tiredness or fatigue
      • nocturia (waking from sleep to urinate)
      • choking during sleep
      • sleep fragmentation or insomnia
      • cognitive dysfunction or memory impairment

    Be aware that there is a higher prevalence of OSAHS in people with any of the following conditions:

    • obesity or overweight
    • obesity or overweight in pregnancy
    • treatment-resistant hypertension
    • type 2 diabetes
    • cardiac arrythmia, particularly atrial fibrillation
    • stroke or transient ischaemic attack
    • chronic heart failure
    • moderate or severe asthma
    • polycystic ovary syndrome
    • Down's syndrome
    • non-arteritic anterior ischaemic optic neuropathy (sudden loss of vision in 1 eye due to decreased blood flow to the optic nerve)
    • hypothyroidism
    • acromegaly
  • or
  • features of nocturnal hypoventilation such as:
    • waking headaches
    • peripheral oedema
    • hypoxaemia (arterial oxygen saturation less than 94% on air)
    • unexplained polycythaemia

Reference:

Related pages:

obstructive sleep apnoea - hypopnoea syndrome (OSAHS)

assessment scales and tests for suspected COPD (chronic obstructive pulmonary disease)-OSAHS (obstructive sleep apnoea/hypopnoea syndrome) overlap syndrome

prioritising people for rapid assessment by a sleep service - for suspected COPD (chronic obstructive pulmonary disease)-OSAHS

diagnostic tests for COPD (chronic obstructive pulmonary disease)-OSAHS (obstructive sleep apnoea/hypopnoea syndrome) overlap syndrome

NICE guidance - treatments for COPD (chronic obstructive pulmonary disease) - OSAHS (obstructive sleep apnoea/hypopnoea syndrome) overlap syndrome

follow-up and monitoring for people with COPD (chronic obstructive pulmonary disease)-OSAHS (obstructive sleep apnoea/hypopnoea syndrome) overlap syndrome