Nocturnal CPAP improves walking capacity in COPD patients with obstructive sleep apnoea.

Abstract

BACKGROUND:

Exercise limitation is an important issue in patients with chronic obstructive pulmonary disease (COPD), and it often co-exists with obstructive sleep apnoea (overlap syndrome). This study examined the effects of nocturnal continuous positive airway pressure (CPAP) treatment on walking capacity in COPD patients with or without obstructive sleep apnoea.

METHODS:

Forty-four stable moderate-to-severe COPD patients were recruited and completed this study. They all underwent polysomnography, CPAP titration, accommodation, and treatment with adequate pressure. The incremental shuttle walking test was used to measure walking capacity at baseline and after two nights of CPAP treatment. Urinary catecholamine and heart rate variability were measured before and after CPAP treatment.

RESULTS:

After two nights of CPAP treatment, the apnoea-hypopnoea index and oxygen desaturation index significantly improved in both overlap syndrome and COPD patients, however these changes were significantly greater in the overlap syndrome than in the COPD group. Sleep architecture and autonomic dysfunction significantly improved in the overlap syndrome group but not in the COPD group. CPAP treatment was associated with an increased walking capacity from baseline from 226.4 ± 95.3 m to 288.6 ± 94.6 m (P < 0.05), and decreased urinary catecholamine levels, pre-exercise heart rate, oxygenation, and Borg scale in the overlap syndrome group. An improvement in the apnoea-hypopnoea index was an independent factor associated with the increase in walking distance (r = 0.564).

CONCLUSION:

Nocturnal CPAP may improve walking capacity in COPD patients with overlap syndrome.

TRIAL REGISTRATION:

NCT00914264.

• Authors: Tsai-Yu Wang, Yu-Lun Lo, Kang-Yun Lee, Wen-Te Liu, Shu-Min Lin, Ting-Yu Lin, Yung-Lun Ni, Chao-Yung Wang, Shu-Chuan Ho, Han-Pin Kuo
• Journal: Respiratory research (Respir Res) Vol. 14 Pg. 66 (Jun 19 2013) ISSN: 1465-993X [Electronic] England
• PMID: 23782492 (Publication Type: Journal Article, Observational Study)

Chemical References

• Catecholamines

Topics

• Aged
• Catecholamines (urine)
• Continuous Positive Airway Pressure
• Female
• Heart Rate
• Humans
• Male
• Middle Aged
• Polysomnography
• Prospective Studies
• Pulmonary Disease, Chronic Obstructive (complications, physiopathology, therapy)
• Respiratory Function Tests
• Sleep Apnea, Obstructive (complications, physiopathology, therapy)
• Walking