Fixed-pressure nCPAP in patients with obstructive sleep apnea (OSA) syndrome and chronic obstructive pulmonary disease (COPD): a 24-month follow-up study.
OBJECTIVE
The aim of this study was to investigate the time course of body weight, daytime sleepiness, and functional cardiorespiratory parameters in patients with both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSA), after institution of domiciliary nasal continuous positive airway pressure (nCPAP).


METHODS
Twelve consecutive obese outpatients (mean age = 61 +/- 11 years; four women) were evaluated before (baseline) and after 3, 12, and 24 months of nocturnal nCPAP (4 h per night).


RESULTS
At baseline, all patients were hypercapnic and hypoxemic, suffering from night desaturation (T (90) is the percentage of total recording time (TRT) spent with SaO(2) <or= 90% = 38 +/- 2%) and sleepy (Epworth sleepiness scale [ESS] = 16.58 +/- 0.86). Three months after the implementation of nCPAP, daytime PaCO(2) and PaO(2) improved up to 45.1 +/- 0.9 and 69.0 +/- 1 mmHg, respectively; mean pulmonary artery pressure (MPAP) decreased from 24.7 +/- 1.1 to 19.2 +/- 04 mmHg. All other variables showed progressive improvements up to 12 months. At 3 and 12 months, mean body mass index was slightly decreased (to 31.6 +/- 0.2 and 30.7 +/- 0.1 kg/m(2), respectively); daytime sleepiness, nocturnal O(2) desaturation, and maximal inspiratory pressure were also improved and thereafter remained stable.


CONCLUSIONS
In conclusion, in our patients with both severe OSA and mild-to-moderate COPD, arterial blood gasses and MPAP improved and stabilized after 3 months of nCPAP therapy, with the greatest improvements being in ESS score, T (90), and maximal inspiratory force from 3 up to 12 months; these parameters remained stable over the following 12 months. Finally, our data support early treatment with nCPAP in such patients.
Toraldo
Domenico Maurizio
DM
A. Galateo Lung Disease Hospital, Third Division ASL/Lecce, San Cesario di Lecce, Lecce, Italy. d.torald@tin.it
De Nuccio
Francesco
F
Nicolardi
Giuseppe
G
D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002245:Carbon Dioxide / Q000097:blood; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure / Q000379:methods* / Q000706:statistics & numerical data; D006970:Disorders of Excessive Somnolence / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010100:Oxygen / Q000097:blood; D017286:Polysomnography / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D018709:Statistics, Nonparametric
D002245:Carbon Dioxide; D010100:Oxygen