Prevalence Of Overlap Syndrome Research Articles

Predictors of obstructive sleep apnea in patients with chronic obstructive pulmonary disease

BackgroundThe co-existence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome, and both conditions share common risk factors and are associated with co-morbidities and poor outcomes.MethodologySixty stable COPD patients were included in the study. We assessed body measurements, pulmonary functions to diagnose and assess COPD severity, arterial blood gases, STOB-BANG questionnaire (SBQ), Epworth sleepiness scale (ESS), and polysomnography (PSG) for diagnosis and classification of OSA severity. The aim of the study is to assess predictors of OSA among COPD patients.ResultsThe prevalence of overlap syndrome was 70% among studied stable COPD patients, with a male-to-female ratio of 2:1, and SBQ and ESS were statistically higher in overlap syndrome with p values < 0.001 and 0.002, respectively. Oxygen desaturation index (ODI) was 42.72 ± 30.02 for overlap in comparison to 13.18 ± 5.80 for COPD with a significant p value of < 0.001, and T90 was significantly increased in the overlap group (26.75 ± 10.37) than the COPD-only group (1.8 ± 0.98, p value ≤ 0.001). We found a direct correlation between the GOLD stage and severity of OSA in overlap syndrome. The best cutoff value for the detection of overlap syndrome was ESS = 9 (sensitivity = 88.6% and specificity = 62.5%) and SBQ = 5 (sensitivity = 63.6% and specificity = 93.8%).ConclusionOverlap syndrome represents 70% of stable COPD patients. A direct relation was found between the GOLD stage and OSA severity in overlap syndrome. ESS and SBQ can be used for screening for OSA in COPD patients but with a lower cutoff value than those used for the general population.Trial registrationRetrospectively registered, registration number is NCT05605431, date of registration October 29, 2022.

Оverlap-syndrome in pediatric practice

The problem of combined pathology in childhood has an important medical and social aspect. To date, aspects of the pathogenesis of the overlap syndrome are being considered and studied. Despite reliable data on the factors in the development of overlap syndrome in clinical practice, the eff ectiveness of diagnosis and treatment is still low. This review summarizes the current scientifi c data from epidemiological studies of various types of overlap syndrome, therapeutic approaches, and also analyzes a rare clinical case in pediatrics.The purpose of the review is to present an analysis of current literature data on the prevalence of overlap syndrome in pediatric practice.

Overlap syndrome: association of gastroesophageal reflux disease with dyspepsia syndrome in schoolchildren

The combination of gastroesophageal reflux disease with dyspepsia syndrome in a particular patient is designated as overlap syndrome, the problem of which is widely discussed.Purpose. To study the regional characteristics of the association of gastroesophageal reflux disease with dyspepsia syndrome in Siberian schoolchildren with gastrointestinal complaints.Materials and methods. Schoolchildren of Siberia 7–17 years old were examined: in Tyva (1535 children), Buryatia (790 children), and Evenkia (1369 children). Information about gastroenterological complaints was collected. By the method of random selection, children with gastroenterological complaints underwent esophagogastroduodenoscopy in Tyva, 283 children, in Buryatia, 110 children, and in Evenkia, 205 children. The studies were approved by the ethics committee and the consent of the patients and their parents was obtained.Results. In Siberian schoolchildren, the prevalence of GERD and DS overlap syndrome was 4.7%. In Tyva, the overlap of gastroesophageal reflux disease with dyspepsia syndrome in schoolchildren was found most often: 6.9%, which was significantly higher than in Buryatia (3.7%; p = 0.0016) and in Evenkia (2.8%; p = 0.0001). regional features have been established in the distribution of clinical variants of dyspepsia associated with gastroesophageal reflux disease in schoolchildren. So, in the children of Buryatia and Evenkia, the dominant association was gastroesophageal reflux disease with postprandial distress syndrome, in Tyva — with epigastric pain. Among endoscopically examined schoolchildren in the absence of erosive and ulcerative diseases, similar associative relationships between gastroesophageal reflux disease with dyspepsia syndrome and its clinical variants were determined.Conclusion. Regional differences were established, both in the prevalence of overlap syndrome and the severity of the association of gastroesophageal reflux disease with variants of the clinical course of dyspepsia syndrome. It is not unlikely that overlapping disorders are united by a single leading pathomechanism in their formation.

The prevalence and significance of anti-PM/Scl antibodies in systemic sclerosis.

Anti-PM/Scl (a-PM/Scl) antibodies are found in different systemic autoimmune diseases such as polymyositis, dermatomyositis, systemic sclerosis (SSc) and overlap syndromes. According to literature, they are detected in approx. 2% of SSc patients, but their presence is more common in SSc with myositis overlap. The aim of the study was to assess the prevalence of a-PM/Scl in patients with SSc and to identify differences in the clinical profile of the disease in patients with the presence of a-PM/Scl. The study was performed on 126 European Caucasian SSc patients (98 females and 28 males) hospitalized consecutively in the Department of Rheumatology and Connective Tissue Diseases. The study group was analyzed for the potential presence of a-PM/Scl using a commercial test - EUROLINE Systemic Sclerosis Profile. The detection and interpretation were carried out electronically using the specific Euroimmun - EUROLineScan programme. The subtype of SSc, incidence of internal organ involvement and serological profile were determined in the entire group. Due to the presence of a-PM/Scl, patients were divided into two groups: a-PM/Scl (+) SSc - 22 patients and a-PM/Scl (-) SSc - 104 patients. A-PM/Scl was detected in 22/126 patients with SSc (17.5%). A strong correlation was found between a-PM/Scl and myalgia or myositis (p = 0.0379), hand joints contractures (p = 0.0002) and the prevalence of overlap syndrome (p = 0.0142). There were no relationships between the presence of a-PM/Scl and subtypes of SSc, other organ involvement, digital ulcers or calcinosis. Anti-PM/Scl antibodies are fairly common in patients with systemic sclerosis. In SSc, anti-PM/Scl antibodies are frequently associated with myalgia or myositis, hand joint contractures and an overlap syndrome.

Prevalence of Overlap Syndrome. Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease. A study protocol.

Introduction: Chronic obstructive pulmonary disease (COPD) and Obstructive sleep apnea (OSA) cause an inflammatory response and hypoxia. Patients who have both conditions have increased morbidity and mortality. Overlap syndrome between OSA and COPD is important but under-recognised. Objectives: We aimed to determine the prevalence and severity of overlap syndrome in patients with COPD through the overnight standard polysomnography. Methods/Design: A consecutive single-center cross-sectional study will be performed. The design, conduct and report of this study followed the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The sample will be of convenience, recruited consecutively with respiratory complaints that seek care in a private clinic specializing in pulmonology in the city of Cascavel, in the state of Paraná, from September 2016 to July 2017. All subjects will be submitted to the same evaluation protocol described subsequently. Initially will be collected data on baseline demographic, anthropometric and clinical aspects, including body mass index, neck, hip and waist circumferences, respiratory and cardiac rates, peripheral blood pressure, and BODE index. After this phase of the study, patients will perform lung function tests through petismography, sleep studies using the standard overnight PSG, and respond to the Berlin and Pittsburgh questionnaires, and Epworth Sleepiness Scale.

Prevalence of overlap syndrome in chronic obstructive pulmonary disease patients without sleep apnea symptoms.

The co-existence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is a common phenomenon referred to as overlap syndrome (OS). In this study, we evaluated the prevalence of OS in mild hypoxemic COPD patients without OSA symptoms and compared characteristics of OS and COPD patients. Forty-five COPD patients (mean FEV1 1671.3 ± 532.0 mL) with mild hypoxemia presenting no sleep apnea symptoms (96% men, mean age 67.7 ± 8.5 years) were involved in this study. Clinical characteristics were recorded, biochemical analysis and polygraphy were performed. Twenty-six patients with a RDI of ≥15 events/h were defined as OS (58%). When OS (n = 26) and COPD without OSA (n = 19) groups were compared, BMI (29.6 ± 6.6 vs 25.6 ± 4.9 kg/m2 ; P = 0.03), TNF-α level (24.8 ± 8.1 vs 3.6 ± 0.8 ng/mL; P = 0.03) and sleep time with SpO2 < 90% (23.9 ± 29.4 vs 9.7 ± 21.9%; P = 0.02) were significantly increased in OS. Univariate analysis showed a correlation between RDI and BMI (P < 0.01), Epworth score (P = 0.050), COPD exacerbation frequency (P = 0.046) and TNF-α (P = 0.048). However, multivariate linear regression analysis revealed a significant correlation only between RDI and BMI (P < 0.01). BMI as a predictor of OSA was examined through ROC curve analysis and the area under curve was 0.691 (P = 0.03). To identify OS patients, BMI > 27.2 kg/m2 had a sensitivity of 73% and specificity of 68%. This findings support that high prevalence (58%) of OS in COPD patients without OSA symptoms is related to BMI. Therefore, sleep study should be considered in especially overweight or obese COPD patients, even in those without sleep apnea symptoms.

Lack of Benefit of Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome

Obstructive sleep apnea (OSA) has been shown to be an inflammatory stimulus and may potentially result in a deterioration in the respiratory status of patients with coexistent chronic obstructive pulmonary disease (COPD) (overlap syndrome). We hypothesized that with treatment of OSA, there would be an improvement in coexistent COPD in overlap patients. We also sought to characterize overlap patients by comparing them with patients with either OSA or COPD alone. We performed a retrospective study of patients who attended a university-affiliated Veterans Affairs hospital. Demographic and clinical data were obtained from the medical charts and pharmacy records for the preceding two years and for the two years following the initiation of continuous positive airway pressure (CPAP) therapy. Overlap patients had moderately severe sleep apnea (AHI 28.6 +/- 4.2) and moderately severe COPD (FEV1= 1.94 +/- 0.10 L). The prevalence of overlap syndrome in COPD patients was 11.9%, and 41% in OSA patients. Overlap patients who were compliant with CPAP therapy experienced a greater decrease in FEV1, percent predicted FEV1, percent decrease in FEV1, FVC, percent predicted FVC, and percent decrease in FVC when compared with noncompliant patients. A very strong correlation was found between the average hours of CPAP use per day and the percent decrease in FEV1 (r = 0.69, p = 0.003). There was a similar strong correlation for the decrease in FEV1 and percent predicted FEV1. OSA is common in COPD patients; similarly, COPD is common in OSA patients. Treatment of OSA with CPAP therapy in patients with overlap syndrome may not lead to an improvement in the coexistent COPD.