Overlap Syndrome

Abstract

Purpose of Review

This paper aims to critically evaluate recent literature on the epidemiology, pathophysiology, and management of overlap syndrome (OS).

Recent Findings

The prevalence of OS is much higher in patients with either chronic obstructive pulmonary disease (COPD) or obstructive sleep apnea (OSA) (8.1%–65.9%) than in the general population (1–2%). Maladaptive neural, inflammatory, cardiovascular, and autonomic responses are intensified with the coexistence of both conditions, leading to worse diurnal and nocturnal respiratory function. Careful analysis of the oximetry and capnography findings during polysomnography can detect concomitant sleep-related hypoxemia/hypoventilation. Observational studies report salutary effects of CPAP on gas exchange, COPD exacerbation, sexual dysfunction, and mortality.

Summary

COPD or OSA patients should be routinely screened for the presence of OS, since CPAP therapy can improve clinical outcomes. Future studies should investigate the pathophysiological interactions resulting from combined risk factors (smoking and obesity), the impact of oxygen on clinical outcomes, and the role of other positive airway pressure modalities.

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