Коморбидность синдрома обструктивного апноэ сна и хронической обструктивной болезни легких

Abstract

Chronic obstructive pulmonary disease (COPD) is a global health system and economic problem due to high levels of morbidity and mortality. Comorbidity of OSA and COPD aggravates respiratory failure, pulmonary hypertension, heart failure and can be a direct cause of mortality. The purpose of the research: to reveal the frequency of occurrence and features of the course of OSA and nocturnal hypoxemia in patients with moderate and severe COPD. Methods. 43 patients (men) with moderate and severe COPD were enrolled in the study. The clinical and functional examination included assessment of respiratory function parameters and a 6-minute step test, a survey using the validated questionnaires CAT-test, the Berlin Sleep Apnea Questionnaire, the Epworth Sleepiness Scale, pulse oximetry, and respiratory sleep diagnostic. Results. According to the results of respiratory monitoring, the frequency of obstructive sleep apnea syndrome in moderate and severe COPD is 60.5%. The incidence of OSAS did not differ significantly depending on the severity of COPD. A feature of the comorbidity of OSA and COPD is the frequent presence of nocturnal hypoxemia - in most patients (84.6%). The frequency and severity of nocturnal hypoxemia does not depend on the severity of sleep apnea in moderate to severe COPD. It was noteworthy that OSA, detected in patients with moderate and severe COPD, required the appointment of CPAP therapy (Continuous Positive Airway Pressure), which amounted to 32.6%. Conclusions. The severity of OSA in patients with COPD does not affect the frequency and severity of nocturnal hypoxemia. This indicates the need for early diagnosis of sleep-disordered breathing and the severity of hypoxemia in patients with moderate and severe COPD. These diagnostic studies will help identify the category of patients in need of appropriate respiratory correction. These results of the study indicate the importance of active detection of comorbid pathologies in COPD, in particular, examination of patients for the presence of obstructive sleep apnea syndrome. Correction of OSA will improve the quality of life and survival of patients with COPD.