Viraj Jain, Harshill Modi, Moon Park, Anil Ghimire, Lourdes M DelRosso
{"title":"COPD患者夜间低氧血症：OSA和PLMS合并症对氧去饱和的放大作用。","authors":"Viraj Jain, Harshill Modi, Moon Park, Anil Ghimire, Lourdes M DelRosso","doi":"10.1177/17534666251380431","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>To examine the independent and interactive effects of COPD, OSA, and PLMS on nocturnal oxygen desaturation.</p><p><strong>Design: </strong>Cross-sectional analysis of a sleep study cohort.</p><p><strong>Methods: </strong>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 SpO<sub>2</sub> were compared across COPD and OSA/PLMS subgroups. Multivariable regression tested the independent and interaction effects of COPD, OSA, PLMS, age, and sex.</p><p><strong>Results: </strong>Participants with COPD had lower mean SpO<sub>2</sub> and longer ST than non-COPD participants (<i>p</i> < 0.005). ST was greatest in those with both OSA and PLMS, particularly in COPD. COPD (+46.4 min, <i>p</i> < 0.001) and OSA (+10.5 min, <i>p</i> = 0.009) independently increased ST. A negative COPD × OSA interaction (<i>p</i> = 0.021) indicated less-than-additive effects, whereas a positive COPD × OSA × PLMS interaction (<i>p</i> = 0.036) identified the highest desaturation burden.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251380431"},"PeriodicalIF":3.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444068/pdf/","citationCount":"0","resultStr":"{\"title\":\"Nocturnal hypoxemia in COPD: the amplifying effect of comorbid OSA and PLMS on oxygen desaturation.\",\"authors\":\"Viraj Jain, Harshill Modi, Moon Park, Anil Ghimire, Lourdes M DelRosso\",\"doi\":\"10.1177/17534666251380431\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>To examine the independent and interactive effects of COPD, OSA, and PLMS on nocturnal oxygen desaturation.</p><p><strong>Design: </strong>Cross-sectional analysis of a sleep study cohort.</p><p><strong>Methods: </strong>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 SpO<sub>2</sub> were compared across COPD and OSA/PLMS subgroups. Multivariable regression tested the independent and interaction effects of COPD, OSA, PLMS, age, and sex.</p><p><strong>Results: </strong>Participants with COPD had lower mean SpO<sub>2</sub> and longer ST than non-COPD participants (<i>p</i> < 0.005). ST was greatest in those with both OSA and PLMS, particularly in COPD. COPD (+46.4 min, <i>p</i> < 0.001) and OSA (+10.5 min, <i>p</i> = 0.009) independently increased ST. A negative COPD × OSA interaction (<i>p</i> = 0.021) indicated less-than-additive effects, whereas a positive COPD × OSA × PLMS interaction (<i>p</i> = 0.036) identified the highest desaturation burden.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":22884,\"journal\":{\"name\":\"Therapeutic Advances in Respiratory Disease\",\"volume\":\"19 \",\"pages\":\"17534666251380431\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444068/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Respiratory Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17534666251380431\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Respiratory Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17534666251380431","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/17 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Nocturnal hypoxemia in COPD: the amplifying effect of comorbid OSA and PLMS on oxygen desaturation.
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.
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