Clinical characteristics of patients with COPD and obstructive sleep apnea or other comorbidities / 中华健康管理学杂志

ABSTRACT

Objective:To assess the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) or other comorbidities.Methods:In this cross sectional study, a total of 2 090 patients with confirmed COPD which came from Renmin Hospital of Wuhan University from August 2017 to October 2021 were included to investigate the prevalence of comorbidities (hypertension, diabetes, cardiovascular disease, cerebrovascular disease, metabolic diseases and osteoporosis) and clinical characteristics. All subjects underwent overnight polysomnography, clinical symptom questionnaire and sleep questionnaire. The data of baseline, blood biochemistry, arterial blood gas, lung function, sleep questionnaire, sleep monitoring and other indicators were compared between group with COPD only and with COPD and OSA.Results:55.84% of COPD patients (1 167/2 090) with OSA were included in the study. By analyzing the prevalence of comorbidities (hypertension, diabetes, cardiovascular disease, cerebrovascular disease, metabolic diseases and osteoporosis), this study found that only the prevalence of hypertension was significantly higher in the group with COPD and OSA ( P<0.01) when compared with the COPD only group (35.2%). As the severity of OSA increased in COPD patients, the incidence of hypertension increased. The prevalence of hypertension was 35.2%, 37.5%, 44.9%, 53.2% in non-OSA, mild, moderate, and severe OSA patients, respectively. By binary logistic regression analysis, the BMI ( OR=1.067, 95% CI 1.043-1.091, P<0.01) , neck circumference ( OR=1.019, 95% CI 1.002-1.036, P<0.05), smoking history ( OR=1.345, 95% CI 1.028-1.760, P<0.05), hypertension ( OR=1.249, 95% CI 1.024-1.522, P<0.05) were regarded as independent risk factors for patients with COPD and OSA. Conclusions:COPD patients have a high rate of OSA. In clinical practice, greater emphasis on primary/secondary prevention should be paid to COPD patients with OSA and hypertension. The management and intervention of OSA and hypertension may improve the prognosis of CODP patients.