000162380 001__ 162380
000162380 005__ 20251017144654.0
000162380 0247_ $$2doi$$a10.14814/phy2.70438
000162380 0248_ $$2sideral$$a144855
000162380 037__ $$aART-2025-144855
000162380 041__ $$aeng
000162380 100__ $$aRaphelson, Janna
000162380 245__ $$aObstructive sleep apnea severity and pathophysiological traits in overlap syndrome: Insights from the <scp>SNOOzzzE</scp> cohort
000162380 260__ $$c2025
000162380 5060_ $$aAccess copy available to the general public$$fUnrestricted
000162380 5203_ $$aThe overlap syndrome (OVS), defined as coexisting chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA), is linked to worse outcomes than either condition alone. Patients with COPD and OSA may have fewer obstructive events, but underlying mechanisms remain unclear. Using a large clinical cohort, we tested the hypothesis that OSA severity and pathophysiological traits differ in OVS versus OSA‐alone. Data from the SNOOzzzE cohort (3319 adults with in‐laboratory polysomnography 2017–2019) were used. OVS patients were identified through chart review and matched to OSA‐only patients (3:1) by age, sex, and body mass index. OSA severity was assessed using apnea hypopnea index (AHI), hypoxic burden (HB), and T90 (%time with SpO2 < 90%), while OSA traits were quantified from polysomnographic signals via validated algorithms. Mixed model analysis quantified group differences before and after adjustment for covariate differences (Black race, smoking) accounting for matching as a random effect. In our diverse cohort (103 OVS vs. 309 OSA‐only; 38% women, 44% non‐White, 17% Hispanic), OVS patients tended to have a lower AHI and HB (approximately −10%, p < 0.1), but significantly higher T90 (~50%, p = 0.003). OVS patients had less upper airway collapsibility, lower arousal threshold, lower ventilatory response to arousal (p < 0.05) and tended to have higher upper airway dilator muscle compensation (p = 0.09). In adjusted analyses, effect estimates were similar, but significance was attenuated. Hyperinflation and air trapping were inversely associated with AHI/HB. OSA severity and mechanisms differ in OVS versus OSA‐only. Future research should seek to evaluate these differences for their prognostic ability.
000162380 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI12-02175$$9info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI15-01940$$9info:eu-repo/grantAgreement/ES/ISCIII/PI18-01524
000162380 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000162380 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000162380 700__ $$aSanchez-Azofra, Ana
000162380 700__ $$aOrr, Jeremy E.
000162380 700__ $$aParra, Gabriela
000162380 700__ $$aMcGinnis, Lana
000162380 700__ $$aSalinas, Alexis
000162380 700__ $$aLuu, Steven
000162380 700__ $$aSands, Scott A.
000162380 700__ $$aAzarbarzin, Ali
000162380 700__ $$aOwens, Robert L.
000162380 700__ $$0(orcid)0000-0001-9096-2294$$aMarin, Jose M.$$uUniversidad de Zaragoza
000162380 700__ $$aMalhotra, Atul
000162380 700__ $$aSchmickl, Christopher N.
000162380 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000162380 773__ $$g13, 13 (2025), 12 pp.$$pPhysiol. reports$$tPhysiological Reports$$x2051-817X
000162380 8564_ $$s821269$$uhttps://zaguan.unizar.es/record/162380/files/texto_completo.pdf$$yVersión publicada
000162380 8564_ $$s2564035$$uhttps://zaguan.unizar.es/record/162380/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000162380 909CO $$ooai:zaguan.unizar.es:162380$$particulos$$pdriver
000162380 951__ $$a2025-10-17-14:37:36
000162380 980__ $$aARTICLE