COPD and Sleep Apnea

If you have chronic obstructive pulmonary disorder (COPD), you may also have obstructive sleep apnea (OSA), a sleep disorder characterized by episodes of paused breathing during sleep. Research has shown that there is a physiological link between the conditions, the combination (comorbidity) of which is known as COPD-OSA overlap syndrome (OVS).

While either of these issues can have its own impact on your health, each can exacerbate the other. Together, they can compound concerns such as decreased oxygen levels, cardiovascular issues, and more.

If you have COPD, early identification and treatment of OSA can help reduce these harmful health complications.

Connections and Complications

OSA and COPD are linked in terms of causative risk factors and health complications.

COPD is an obstructive lung disease that includes emphysema and chronic bronchitis. With OSA, your tongue and throat muscles collapse during sleep and block your airway. Lung inflammation is a major contributor to both conditions, and systemic (body-wide) inflammation present with each increases the risk of OVS.

Further, researchers suggest that lung hyperinflation and the trapping of air in the lungs that occur with COPD can reduce the body's response to low oxygen during sleep, contributing to the development of OVS.

Serious health effects may develop with these respiratory diseases. COPD and OSA both cause hypoxia (low oxygen in the body's tissues) and hypoxemia (low oxygen in the blood).

COPD and OSA each increase the risk of heart disease, and their coexistence may further increase cardiovascular risks such as:

• Arrhythmias (Irregular heartbeat)
• High blood pressure
• Heart attack
• Stroke

People with overlap syndrome may also have:

• An increased risk of hypercapnia (elevated carbon dioxide level)
• An increased prevalence of pulmonary hypertension (high pressure in the blood vessels within and around the lungs)
• Cor pulmonale (right-sided heart failure)
• Higher morbidity rates

When combined in COPD-OSA overlap syndrome, these health issues may be life-threatening.

Recognizing Sleep Apnea

Some of the symptoms of COPD and OSA overlap—excessive daytime sleepiness, generalized fatigue, trouble concentrating, and irritability. So if you have COPD, it is important to be on the lookout for additional signs of OSA.

Apneic episodes during sleep are the most distinctive symptom of OSA. During an apneic episode, you may stop breathing for up to 10 seconds or more. After an episode, you may awaken abruptly with a loud gasp or snort.

You or your partner might notice these episodes, as they interrupt your sleep. The number of apneic events you experience may be as high as 20 to 30 per hour of sleep or more.

Other symptoms of OSA include:

• Snoring
• Sore throat
• Not feeling refreshed after eight to 10 hours of nighttime sleep
• Morning headache
• Bedwetting
• Impotence

When you have COPD, apneic episodes may also be associated with shortness of and trouble catching your breath.

Treatment

The focus of treatment for COPD-OSA overlap typically includes strategies that are also used for OSA alone. A combination of treatments is common in managing a comorbidity.

Your healthcare provider may recommend the following for your COPD-OSA overlap treatment:

• Weight loss
• Tongue-retaining devices or bite guards
• Continuous positive airway pressure (CPAP)

If your OSA is severe or does not improve with nonsurgical management, your practitioners may discuss the following procedures with you:

• Uvulopalatopharyngoplasty (UPPP)
• Laser-assisted uvulopalatoplasty (LAUP)
• Gastric bypass surgery (when OSA is due to morbid obesity)
• Tracheostomy
• Jaw surgery

These procedures are invasive, entail a long recovery, and yield mixed results in terms of OSA symptom improvement. But, depending on your situation, surgery may be beneficial for you.

A Word From Verywell

If you have COPD and are having sleep issues, it's important to discuss this immediately with your healthcare provider. COPD can affect your blood oxygen levels and your heart—and sleep apnea may make matters worse.

You may be suffering from OSA and not be aware of it, especially if you live alone. Paying close attention to your sleep patterns and your daytime symptoms will help you recognize a potential problem so you can have an evaluation and get started on treatment if you need it.