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

ABSTRACT: 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.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.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?

SUBMITTER: Wang TY

PROVIDER: S-EPMC3689615 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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

Wang Tsai-Yu TY Lo Yu-Lun YL Lee Kang-Yun KY Liu Wen-Te WT Lin Shu-Min SM Lin Ting-Yu TY Ni Yung-Lun YL Wang Chao-Yung CY Ho Shu-Chuan SC Kuo Han-Pin HP

Respiratory research 20130619

<h4>Background</h4>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.<h4>Methods</h4>Forty-four stable moderate-to-severe COPD patients were recruited and completed this study. They all underwent ...[more]

PMID: 23782492

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Project description:ObjectiveTo investigate the effect of continuous positive airway pressure (CPAP) treatment on cognitive function in stroke patients with obstructive sleep apnoea (OSA) by exploring randomised controlled trials (RCTs).MethodsPublished RCTs that assessed the therapeutic effects of CPAP on cognition in stroke patients with OSA, compared with controls or sham CPAP, were included. Electronic databases, including MEDLINE, Embase and Cochrane library, were searched in October 2020 and October 2021. Risk of bias was assessed using the Cochrane collaboration tools. A random effects or fixed effects model was used according to heterogeneity. The outcomes were global cognitive gain, improvement in cognitive domain and subjective sleepiness.Results7 RCTs, including 327 participants, comparing CPAP with control or sham CPAP treatment were included. 6 RCTs with 270 participants reported results related to global cognition, and CPAP treatment had no significant effects on global cognitive gain in stroke patients with OSA (standardised mean difference (SMD), 0.18; 95% CI, -0.07 to 0.42; p=0.153). A subgroup analysis showed that an early start to (<2 weeks post stroke) CPAP treatment after stroke significantly improved global cognition (SMD, 0.66; 95% CI, 0.18 to 1.14; p=0.007), which was not found in the case of a delayed start to CPAP treatment. However, CPAP did not significantly help with memory, language, attention or executive function. Moreover, CPAP therapy significantly alleviated subjective sleepiness (SMD, -0.73; 95% CI, -1.15 to -0.32; p≤0.001).ConclusionsEarly initiation of CPAP treatment might contribute to improvement in global cognition in stroke patients with OSA. This study had the following limitations: the sample size in each included study was relatively small; the scales related to cognitive assessment or subjective sleepiness were inconsistent; and the methodological quality was not high. Future trials should focus on including a greater number of stroke patients with OSA undergoing CPAP treatment.Prospero registration numberCRD42020214709.

Dataset Information

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

Publications

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

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