The triad of obstructive sleep apnea syndrome, COPD, and obesity: sensitivity of sleep scales and respiratory questionnaires

Author(s)

Mungo Pissulin, Flavio Danilo ^[1] ; Pacagnelli, Francis Lopes ^[1] ; Alda, Maiara Almeida ^[1] ; Beneti, Ricardo ^[1] ; de Barros, Jefferson Luis ^[2] ; Minamoto, Suzana Tanni ^[2] ; Thereza Weber, Silke Anna ^[2]

Affiliation

^[1] Univ Oeste Paulista UNOESTE, Presidente Prudente, SP - Brazil

^[2] Univ Estadual Paulista, Hosp Clin, Fac Med Botucatu, Botucatu, SP - Brazil

• Document type: Journal article
• Source: Jornal Brasileiro de Pneumologia; v. 44, n. 3, p. 202-206, MAY-JUN 2018.
• Web of Science Citations: 0

Abstract

ABSTRACT Objective: To investigate whether the presence of obstructive sleep apnea syndrome (OSAS) alters the perception of respiratory symptoms and quality of life in COPD patients, by using specific questionnaires, as well as to determine whether scales for assessing daytime sleepiness and for screening for OSAS can be used in the triad of OSAS, COPD, and obesity. Methods: We included 66 patients diagnosed with mild-to-moderate or severe COPD and presenting with a body mass index > 27 kg/m2. After polysomnography, patients completed the Epworth sleepiness scale (ESS), the Berlin questionnaire (BQ), the modified Medical Research Council (mMRC) scale, the Baseline Dyspnea Index (BDI), and the Saint George’s Respiratory Questionnaire (SGRQ). Results: Patients were first divided into two groups: COPD + OSAS (n = 46); and COPD-only (n = 20). The COPD + OSAS group was subdivided into a COPD + mild-to-moderate OSAS group (n = 32) and a COPD + severe OSAS group (n = 14), all of which were compared with the COPD-only group. There was a significant difference in mean FEV1 (L) between the COPD + OSAS groups and the COPD-only group (p = 0.073). The presence of the triad did not lead to significantly higher ESS scores, and scores > 10 had a specificity of 0.58. The BQ did not identify high risk for OSAS in the presence of the triad (specificity of 0.31). There were no significant differences in domain or total scores of the SGRQ between the COPD + OSAS groups and the COPD-only group. Conclusions: The confounding factors present in the triad of OSAS, COPD, and obesity prevented the perception of increased daytime sleepiness and high risk for OSAS. We observed no worsening of dyspnea perception or quality of life. (AU)

• FAPESP's process: 14/18965-5 - Evaluation of quality of life and functional capacity in obese with Chronic Obstructive Pulmonary Disease (COPD) associated with Obstructive Sleep Apnea Syndrome (OSA)
• Grantee: Maiara Almeida Aldá
• Support Opportunities: Scholarships in Brazil - Scientific Initiation