Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are two different conditions affecting breathing. Obstructive sleep apnea is characterized by repeated breathing interruptions during sleep which lead to poor sleep quality. In contrast, chronic obstructive pulmonary disease refers to several lung conditions like chronic bronchitis, asthma, and emphysema, all involving breathing difficulties both during the day and night.

Unfortunately, both OSA and COPD are quite common. COPD affects over 6%, whereas sleep apnea affects about 10% to 30% of the American population. And, studies have estimated that about 1% of people have overlap syndrome, meaning that they have both OSA and COPD.

What Causes Overlap Syndrome?

A recent review suggested that as these conditions are already common on their own, overlap syndrome happens due to chance. But, sleep apnea and COPD are connected in specific ways, including:

• Inflammation – Both OSA and COPD are characterized by inflammation and the inflammation of each condition can worsen the inflammation of the other one.
• Smoking – Cigarette smoking has been closely linked with both conditions since it triggers inflammation that can increase the risk of developing both OSA and COPD.
• Obesity – Being obese is one of the major risk factors for obstructive sleep apnea, increasing the risk for more than 50% in men, and about 20% to 30% in women.

Can Sleep Apnea Increase the Risk of COPD, or Vice Versa?

In short, there isn’t a direct causal relationship between OSA and COPD although they frequently come together. In other words, OSA doesn’t cause COPD, and COPD doesn’t cause OSA. Meanwhile, if you have OSA, it doesn’t mean that you will for sure develop COPD. Likewise, if you have COPD, it doesn’t imply that you will definitely develop OSA too.

Instead, several factors contribute to developing OSA like enlarged tonsils or neuromuscular disorders. Similarly, overexposure to irritants like smoke, fumes, chemicals, and air pollution can contribute to developing COPD. Yet, since both OSA and COPD involve inflammation, they often come together, especially in those who smoke.

What are the Risks of Overlap Syndrome?

Unfortunately, having overlap syndrome increases the risk of developing other health conditions over time. So, the long-term risks of having COPD and OSA include:

• Right-sided heart failure
• High blood pressure
• Abnormal heartbeat
• Stroke
• Pulmonary hypertension

Furthermore, when it comes to short-term risks and side effects, overlap syndrome can result in:

• Breathing difficulties during sleep
• Frequent night time awakenings
• Excessive snoring
• Extreme daytime sleepiness
• Other sleep disorders

When to See a Doctor?

Briefly put, if you suspect you might have OSA, COPD, or both, ensure you consult your doctor as soon as possible. So, call your doctor if you notice:

• Increased snoring
• Poor sleep quality
• Extreme daytime sleepiness
• Increased morning coughing

Then, your doctor can order some tests to diagnose OSA and COPD which might include an overnight oximetry, polysomnography, and arterial blood gas. Depending on the results, your doctor will suggest the best treatment for your condition and provide you with all the needed information about the condition you have and how to manage it.

Finally, once you get diagnosed and start your treatment, ensure you visit your doctor on a regular basis as both OSA and COPD are chronic conditions that require regular monitoring of your progress.