000165683 001__ 165683
000165683 005__ 20260113234334.0
000165683 0247_ $$2doi$$a10.1513/AnnalsATS.202501-030OC
000165683 0248_ $$2sideral$$a145295
000165683 037__ $$aART-2025-145295
000165683 041__ $$aeng
000165683 100__ $$0(orcid)0000-0001-9096-2294$$aMarin, Jose M.$$uUniversidad de Zaragoza
000165683 245__ $$aSleep-disordered Breathing in Patients with Chronic Obstructive Pulmonary Disease: Prevalence and Outcomes
000165683 260__ $$c2025
000165683 5060_ $$aAccess copy available to the general public$$fUnrestricted
000165683 5203_ $$aRationale: The prevalence of obstructive sleep apnea (OSA) or nocturnal hypoxemia without OSA (i.e., isolated nocturnal hypoxemia [iNH]) and its impact on the natural history of chronic obstructive pulmonary disease (COPD) are unclear.
Objective: We determined the prevalences of OSA and iNH in patients with COPD and their contribution to all-cause mortality and COPD exacerbations.
Methods: At baseline, we performed home sleep apnea testing in the CHAIN (COPD History Assessment in Spain) study cohort. OSA was defined by an apnea–hypopnea index of ⩾15 events per hour, and iNH was defined by an oxygen saturation as measured by pulse oximetry <90% for >30% of the nocturnal recording time. During an observation time of 6.5 years, we evaluated the association of OSA or iNH with all-cause mortality using multivariable Cox regression models and with COPD exacerbations using negative binomial models.
Results: Among 428 patients with COPD, OSA and nocturnal hypoxemia were ruled out in 41%, whereas 27% had iNH and 32% had OSA (i.e., COPD/OSA “overlap syndrome” [OVS]). OVS was independently associated with obesity as defined by a body mass index ⩾30 kg/m2 and with severe COPD exacerbations (P < 0.01), whereas iNH was associated with lower forced expiratory volume in 1 second and lower resting arterial oxygen saturation. Compared with patients with COPD without OSA or iNH, those with untreated OVS had greater risks of mortality (hazard ratio, 1.74; 95% confidence interval, 1.03–2.94) and COPD exacerbations (incidence rate ratio, 1.44; 95% confidence interval, 1.05–2.03).
Conclusions: OSA and iNH are frequent in patients with COPD, and the prevalences decrease or increase, respectively, with disease severity. Patients with COPD with untreated OVS but not with iNH had a greater risk of all-cause mortality and COPD exacerbations.
000165683 540__ $$9info:eu-repo/semantics/embargoedAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000165683 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000165683 700__ $$aSoriano, Joan B.
000165683 700__ $$0(orcid)0000-0003-0777-3850$$aMarin-Oto, Marta$$uUniversidad de Zaragoza
000165683 700__ $$aDe-Torres, Juan P.
000165683 700__ $$aSeijo, Luis M.
000165683 700__ $$aCabrera, Carlos
000165683 700__ $$aSolanes, Ingrid
000165683 700__ $$aMartinez, Cristina
000165683 700__ $$aToledo-Pons, Nuria
000165683 700__ $$aFeu, Nuria
000165683 700__ $$aAmado, Carlos
000165683 700__ $$aVigil, Laura
000165683 700__ $$aCelli, Bartolome R.
000165683 700__ $$aCasanova, Ciro
000165683 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000165683 773__ $$g22, 8 (2025), 1227-1235$$pAnn. Am. Thorac. Soc.$$tAnnals of the American Thoracic Society$$x2329-6933
000165683 8564_ $$s856592$$uhttps://zaguan.unizar.es/record/165683/files/texto_completo.pdf$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2026-04-07
000165683 8564_ $$s1904528$$uhttps://zaguan.unizar.es/record/165683/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint$$zinfo:eu-repo/date/embargoEnd/2026-04-07
000165683 909CO $$ooai:zaguan.unizar.es:165683$$particulos$$pdriver
000165683 951__ $$a2026-01-13-22:05:51
000165683 980__ $$aARTICLE