Prognosis of the Course of Chronic Obstructive Pulmonary Disease with Obstructive Sleep Apnea-Hypopnea Syndrome

Abstract

The objective: to evaluate the prognosis of 4-year survival in patients with chronic obstructive pulmonary disease (COPD) and concomitant obstructive sleep apnea-hypopnea syndrome (OSAHS).Subjects and Methods. 62 patients with COPD and OSAHS were enrolled in the study, they all had been diagnosed in accordance with the recommendations of GOLD (2017). The clinical and functional examination included assessment of respiratory function parameters and a 6-minute step test, a survey using the validated questionnaire of the dyspnea scale by Medical Research Council (MRC) followed by the calculation of body mass index and the BODE index.Results. Patients with COPD and concomitant OSAHS demonstrated higher intensity of dyspnea, deterioration of functional obstructive disorders, and lower exercise tolerance. The course of the disease was characterized by multiple exacerbations requiring hospitalization, 77.4% of COPD patients with OSAHS suffered from cardiovascular diseases and 95.2% were obese. Evaluation of the integral BODE index in COPD patients with OSAHS showed that only 35.5% of them had a 4-year survival rate exceeding 57%. A strong inverse correlation was established between the BODE index and the maximum desaturation rate (r = -0.78) and the moderate inverse correlation was established between the BODE index and SaO2 (r = -0.37). As a result of a 12-year follow-up (2008-2019), mortality in COPD patients with OSAHS was established in 22.2% of cases, mainly among COPD patients with severe OSAHS.