Therapeutic advances in respiratory disease · 2025
Nocturnal hypoxemia in COPD: the amplifying effect of comorbid OSA and PLMS on oxygen desaturation.
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Jain Viraj, Modi Harshill, Park Moon, Ghimire Anil, DelRosso Lourdes M
Аннотация
BACKGROUND: Chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA), and periodic limb movements of sleep (PLMS) frequently co-occur and may exacerbate nocturnal hypoxemia. Still, their combined effects are not well defined.
OBJECTIVES: To examine the independent and interactive effects of COPD, OSA, and PLMS on nocturnal oxygen desaturation.
DESIGN: Cross-sectional analysis of a sleep study cohort.
METHODS: We analyzed 711 participants (mean age 57.2 ± 17.9 years; 44.4% male), including 48 with COPD. Time with oxygen saturation ⩽88% (ST) and mean SpO2 were compared across COPD and OSA/PLMS subgroups. Multivariable regression tested the independent and interaction effects of COPD, OSA, PLMS, age, and sex.
RESULTS: Participants with COPD had lower mean SpO2 and longer ST than non-COPD participants (p < 0.005). ST was greatest in those with both OSA and PLMS, particularly in COPD. COPD (+46.4 min, p < 0.001) and OSA (+10.5 min, p = 0.009) independently increased ST. A negative COPD × OSA interaction (p = 0.021) indicated less-than-additive effects, whereas a positive COPD × OSA × PLMS interaction (p = 0.036) identified the highest desaturation burden.
CONCLUSION: COPD and OSA independently worsen nocturnal hypoxemia, while the coexistence of COPD, OSA, and PLMS confers the greatest desaturation burden, underscoring the importance of evaluating overlapping conditions in clinical assessment.
OBJECTIVES: To examine the independent and interactive effects of COPD, OSA, and PLMS on nocturnal oxygen desaturation.
DESIGN: Cross-sectional analysis of a sleep study cohort.
METHODS: We analyzed 711 participants (mean age 57.2 ± 17.9 years; 44.4% male), including 48 with COPD. Time with oxygen saturation ⩽88% (ST) and mean SpO2 were compared across COPD and OSA/PLMS subgroups. Multivariable regression tested the independent and interaction effects of COPD, OSA, PLMS, age, and sex.
RESULTS: Participants with COPD had lower mean SpO2 and longer ST than non-COPD participants (p < 0.005). ST was greatest in those with both OSA and PLMS, particularly in COPD. COPD (+46.4 min, p < 0.001) and OSA (+10.5 min, p = 0.009) independently increased ST. A negative COPD × OSA interaction (p = 0.021) indicated less-than-additive effects, whereas a positive COPD × OSA × PLMS interaction (p = 0.036) identified the highest desaturation burden.
CONCLUSION: COPD and OSA independently worsen nocturnal hypoxemia, while the coexistence of COPD, OSA, and PLMS confers the greatest desaturation burden, underscoring the importance of evaluating overlapping conditions in clinical assessment.