The Link Between COPD and Sleep Apnea
COPD (chronic obstructive pulmonary disease) and sleep apnea are common pulmonary diseases. Unfortunately, these two conditions can happen at the same time, an occurrence known as the overlap syndrome of COPD and sleep apnea.
The overlap syndrome of COPD and sleep apnea causes disrupted breathing and long-term health effects like cardiovascular disease, diabetes, and stroke.
That said let’s discuss what the overlap syndrome of COPD and sleep apnea is, its causes, diagnosis, and available treatment options. Let’s go!
What is COPD?
COPD, or chronic obstructive pulmonary disease, is a lung condition that causes long-term breathing problems. COPD is an umbrella term for two conditions chronic bronchitis and emphysema, both of which cause damage to the lungs leading to breathing problems.
Chronic Bronchitis
Chronic bronchitis is a disease that causes inflammation in the airway leading to the secretion of excess mucus. Excessive mucus in the airway brings about breathing difficulties and choking.
Emphysema
Emphysema, on the other hand, is a disease that damages the air sacs (alveoli) in the lungs by weakening their inner walls making it difficult to exhale.
What is Sleep Apnea?
Sleep apnea is a renowned sleep disorder whereby a person’s breathing briefly stops and resumes repeatedly during sleep. Obstructive sleep apnea, which occurs concurrently with COPD, happens when the muscles in the throat relax, thereby blocking the airway.
When the airway is blocked, there is an apnea (a partial pause in breathing) or hypopnea (temporary disruption of airflow). More than five breathing disruptions during sleep need to happen in one night for a person to be diagnosed with obstructive sleep apnea.
Each time the airway collapses, the person briefly wakes up to gasp for air. As a result, they have an inconsistent supply of air which greatly affects sleep quality and quantity.
Obstructive sleep apnea manifests through various symptoms like EDS (excessive daytime sleepiness), high blood pressure, improper cognitive function, and loud snoring. These symptoms are detrimental to the overall quality of a person’s life.
What is The Overlap Syndrome of COPD and Sleep Apnea?
The overlap syndrome of COPD and sleep apnea is a condition whereby a person experiences symptoms of both COPD and sleep apnea concurrently. As indicated above, COPD is a chronic lung condition, while sleep apnea is a sleep disorder.
Persons with the overlap syndrome of COPD and sleep apnea experience a higher level of breathing disruptions, daytime sleepiness, and sleep interruption. Why? Because a combination of COPD and obstructive sleep apnea symptoms results in less oxygen levels during sleep.
According to the ASAA (American sleep apnea association), roughly 50% of people with chronic obstructive pulmonary disease experience sleeping problems also known as sleep apnea.
Overlap syndrome affects 1% of adults and causes hypercapnia and hypoxemia, worse than when a person suffers from either of these conditions individually.
Hypercapnia refers to above-average CO2 levels in the blood. Hypoxemia, on the other hand, refers to below-average oxygen levels in the blood. Both these conditions are detrimental because they interfere with metabolic functions in the body.
What Causes the Overlap Syndrome of COPD and Sleep Apnea?
The overlap syndrome of COPD and sleep apnea is complex because it stems from two different conditions. The causes of COPD and sleep apnea are different, but several factors contribute to their simultaneous occurrence:
Age
Both chronic obstructive pulmonary disease and sleep apnea are common in older people, which means the overlap syndrome is likely to affect older people.
Why are these two conditions common among older people? Because as the human body ages, the windpipe starts to narrow, and the muscles surrounding it weaken, making it more difficult for older people to breathe, increasing the risk of COPD and sleep apnea.
Chronic Inflammation
Inflammation is common in both COPD and sleep apnea. When it affects the airway and lungs, it can cause tissue damage and scarring, leading to COPD. Chronic inflammation in the upper airway during sleep causes breathing difficulties leading to obstructive sleep apnea.
Genetics
Some people are more prone to developing COPD and sleep apnea symptoms because of the genes they inherit from their parents. For instance, if a person’s parents struggled with breathing difficulties, they may struggle with the same.
Obesity
Obesity or weight gain is a known cause of both COPD and sleep apnea. When a person is overweight, there is a higher chance of inflammation in their airway and lungs. Inflammation in the airway and lungs causes blockage leading to breathing difficulties.
Occupational Hazards
Exposure to industrial dust, chemicals, fumes, and other harmful substances can cause COPD. Several studies have also established a link between occupational hazards and sleep apnea.
Narcotics
Narcotics can affect normal breathing patterns during sleep causing obstructive sleep apnea. In addition, they can also cause COPD because they affect lung function.
Smoking
Smoking is a renowned cause of chronic obstructive pulmonary disease but also increases sleep apnea risk. Smoking can cause inflammation in the lungs and nasal cavity, which causes the airway to shrink in volume causing breathing difficulties.
How is The Overlap Syndrome of COPD and Sleep Apnea Diagnosed?
The diagnosis of the overlap syndrome of COPD and sleep apnea involves a clinical exam, pulmonary function tests, and PSGs (polysomnographs).
Clinical Exam
A clinical exam comprises a physical exam, family and medical history assessment as well as evaluating visible symptoms. During the evaluation, a physician may review any lifestyle choices, medical conditions, and prescriptions contributing to overlap syndrome.
Pulmonary Function Tests
Pulmonary function tests like spirometry are used to check lung function and assess the severity of COPD if present. Pulmonary function tests check the amount of air a person inhales, including how fast they do it; this helps to manage COPD.
Sleep Studies
Sleep studies such as PSGs are used to check sleep quality and determine the severity of sleep apnea if present. Sleep studies are done in sleep clinics whereby patients have sensors attached to their bodies to assess blood oxygen levels, brain waves, heart rate, etc.
This data will help determine the presence and severity of obstructive sleep apnea as well as how it may be affecting the person’s overall wellbeing.
It’s worth noting that additional tests are available for overlap syndrome of chronic obstructive pulmonary disease and sleep apnea. These include checking for abnormal levels of carbon dioxide (hypercapnia) and oxygen (hypoxemia) in the blood.
Treatment Options for The Overlap Syndrome of COPD and Sleep Apnea
The treatment options available for the overlap syndrome of chronic obstructive pulmonary disease and sleep apnea typically comprise a combination of treatments used to manage both conditions individually. These treatment options include:
Bronchodilators and Corticosteroids
The first step in treating the overlap syndrome of chronic obstructive pulmonary disease and sleep apnea is combining bronchodilators and corticosteroids.
Bronchodilators unblock the air passages making it easy for oxygen to enter and carbon dioxide to exit the lungs. Corticosteroids, on the other hand, reduce inflammation in the air passages and lungs, allowing for better inhalation and exhalation.
BiPAP Therapy
BiPAP (Bi-level positive airway pressure) therapy is a kind of PAP (positive airway pressure) therapy that delivers varying amounts of pressure during inhalation and exhalation.
This varying amount of pressure is helpful to people struggling with COPD and sleep apnea but have issues exhaling when using CPAP machines.
CPAP Therapy
Treatment for the overlap syndrome of COPD and sleep apnea may include CPAP (continuous positive airway pressure) therapy which is the go-to treatment option for sleep apnea.
CPAP therapy involves a patient wearing a mask that delivers a constant supply of pressure from the CPAP machine to keep their airways open during sleep. This helps reduce apnea episodes improving sleep quality and quantity.
Medication
Medication can also be used to manage symptoms of the overlap syndrome of COPD and sleep apnea. For instance, a doctor may prescribe PDE4 (phosphodiesterase-4) inhibitors because they help reduce inflammation of the airways and lungs, allowing for improved breathing.
Oral Appliances
Oral appliances are an alternative to BiPAP and CPAP therapy in keeping the airways open during sleep. Some of the most common oral appliances include MADs (mandibular advancement devices) mouthguards and TRDs (tongue retaining devices).
Pulmonary Rehabilitation
Pulmonary rehab is an all-inclusive treatment option for COPD, but it can also be used to treat symptoms of the overlap syndrome of COPD and sleep apnea.
This all-inclusive program involves education, support, and workouts for people struggling with COPD. It helps manage COPD symptoms, improving overall wellbeing.
Positional Therapy
Sometimes all that’s needed to reduce the frequency and severity of sleep apnea symptoms is changing one’s sleeping position. This is exactly what positional therapy is about; it encourages sleeping on the side as opposed to sleeping on the back, which opens up the airways.
Lifestyle Improvements
Lifestyle changes or improvements like avoiding alcohol and caffeine, maintaining a healthy weight, and practicing good sleep hygiene can help manage overlap syndrome symptoms.
Final Thoughts
To sum it all up, there is a relationship between COPD and sleep apnea, often referred to as the overlap syndrome of COPD and sleep apnea. This is a very serious condition with multiple risks so if you have COPD and/or sleep apnea symptoms contact a Houston dentist today.
