PMID: 2117188Jan 1, 1990Paper

Chronic lung disease in the sleep apnea syndrome

Lung
E C Fletcher

Abstract

Several well controlled epidemiologic and hemodynamic studies suggest that about 20% of sleep apnea syndrome (SAS) patients will have chronic obstructive pulmonary disease (COPD), and the majority of these patients (with combined diseases) will have pulmonary hypertension. Indeed it has been suggested that only patients with underlying hypoxemia, such as that from COPD, will develop right heart failure in the OSA setting. Experience shows that apnea/COPD patients will have severe hypersomnolence associated with the OSA, cough and dyspnea with the airways disease, and edema and plethora related to chronic hypoxemia. Many patients present with respiratory failure and are diagnosed at the time of initial intubation and mechanical ventilation. Episodic nocturnal hypoxemia may be worsened by a steeper rate of desaturation due to lower alveolar and blood oxygen stores, and longer apneas perhaps contributed to by depressed chemosensitivity. Daytime hypoxemia may also add to the severe hemodynamic disturbances. Since COPD cannot be cured, aggressive treatment of SAS is critical. Past studies have shown that tracheostomy or nasal CPAP in this setting not only leads to resolution of episodic nocturnal desaturation but may lead to rapid i...Continue Reading

References

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Citations

Jun 3, 2008·Sleep & Breathing = Schlaf & Atmung·Murat SonguOzgur Bayturan
Mar 17, 2004·Current Opinion in Pulmonary Medicine·Kesavan Kutty
Jun 7, 2011·Clinical Evidence·Robert Andrew McIvorDavid Charles Todd
Feb 11, 2014·Clinics in Chest Medicine·Gourab ChoudhuryWilliam MacNee
May 8, 2013·Chest·Mario Francesco DamianiOnofrio Resta
Dec 4, 2012·Pediatric Pulmonology·Maria J GutierrezGustavo Nino
Aug 1, 1990·Genitourinary Medicine·J K Oates, D Rowen
Apr 10, 2010·American Journal of Respiratory and Critical Care Medicine·Jose M MarinBartolome R Celli
Aug 2, 2011·American Journal of Physiology. Lung Cellular and Molecular Physiology·Jessica B SnowThomas C Resta
Dec 28, 2002·American Journal of Respiratory and Critical Care Medicine·Mark H SandersUNKNOWN Sleep Heart Health Study

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