Bülent ÇİFTÇİ, Eylem YILDIRIM, Yavuz Selim İNTEPE

OBSTRUKTİF UYKU APNE SENDROMU VE AKCİĞER HASTALIKLARI

Değişik klinik durumların bir araya gelmesiyle, farklı özellik oluşturması overlap terimi ile açıklanmıştır. Kronik obstrüktif akciğer hastalığı (KOAH), astım gibi obstruktif akciğer hastalıkları(OAH)obstruktif uyku apne (OUA) hastalığı ile sıklıkla birbirlerine eşlik eden hastalıklardır. Overlapsendromunda ortaya çıkan morbidite ve mortalite hastalıkların tek başlarına olduklarından anlamlı yüksektir. Sigara içimi, obezite, burun hastalıkları ve kronik enflamasyon ortak risk faktörleridir. Bu derlemede, literatür bilgileri ile OAH ve OUA birlikteliğinin patofizyolojisi ve kliniksonuçları özetlenmiştir.

Obstructive Sleep Apnea and Lung Diseases

The overlap term is explained by the formation of different features by combining different clinical conditions. Obstructive lung diseases (OLD) like chronic obstructive lung disease (COPD), asthma are frequently comorbid diseases with obstructive sleep apnea. The morbidity and mortality that occur in the overlap syndrome are significantly higher than those of the diseases alone. Smoking, obesity, nasal diseaeses and chronin inflammation are common risk factors. In this review, the pathophysiology and clinical results of OLD and OSA overlap were summarized with literature information.

PDF

___

1. American Academy of Sleep Medicine. International classification of Sleep Disorders, 3nded. IL: American Academy of Sleep Medicine, 2014.
2. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease Revised 2011. Global Initiative for Chronic Obstructive Lung Disease (GOLD). http://www. goldcopd.org
3. Türk Toraks Derneği Kronik Obstrüktif Akciğer Hastalığı Tanı ve Tedavi Uzlaşı Raporu. Türk Toraks Dergisi. Mayıs 2010; 11: 5-64.
4. From the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2014. Available from: http://www.ginasthma.org/
5. Türk Toraks Derneği Astım Tanı ve Tedavi Rehbberi, 2014, http:// www.toraks.org.tr/book.aspx?- list=1695&menu=242
6. Ioachimescu OC1, Teodorescu M. Integrating the overlap of obstructive lung disease and obstructive sleep apnoea: OLDOSA syndrome. Respirology. 2013 Apr;18(3):421-31.
7. Bülbül, Y. Kronik obstrüktif akciğer hastalığında uyku sorunları. Güncel Göğüs Hastalıkları Serisi, 2013 1 (1), 80-85.
8. Mieczkowski B, Ezzie ME Update on obstructive sleep apnea and its relation to COPD. Int J Chron Obstruct Pulmon Dis. 2014 Apr 8;9:349-62.
9. Faria AC, da Costa CH, Rufino R. Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD? Int J Gen Med. 2015 Aug 25;8:275-81.
10. Sharma B, Feinsilver S, Owens RL, Malhotra A, McSharry D, Karbowitz S. Obstructive airway disease and obstructive sleep apnea: effect of pulmonary function. Lung. 2011 Feb;189(1):37-41.
11. Gothi D, Gupta SS, Kumar N, Sood K. Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease. Lung India. 2015 Nov-Dec;32(6):578-83.
12. Ferrando M, Bagnasco D, Roustan V, Canonica GW, Braido F, Baiardini I. Sleep complaints and sleep breathing disorders in upper and lower obstructive lung diseases. J Thorac Dis. 2016 Aug;8(8):E716-25
13. Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med. 2010 Aug 1;182(3):325-31.
14. Köktürk O, Çiftçi B. Overlap Sendromu. Tüberküloz ve Toraks Dergisi 2003; 51(3): 333-348.
15. Levi-Valensi P, Weitzenblum E, Rida Z, Aubry P, Braghiroli A, Donner C, Aprill M, Zielinski J, Wurtemberger G. Sleep-related oxygen desaturation and daytime pulmonary haemodynamics in COPD patients. Eur Respir J. 1992;5(3):301–7.
16. Tamai K, Matsuoka H, Suzuki Y, Yoshimatsu H, Masuya D, Nakashima N, et al. Nocturnal Oxygen Desaturation Index is Inversely Correlated with Airflow Limitation in Patients with Chronic Obstructive Pulmonary Disease. COPD. 2016;13(2):235-40.
17. Khatri SB1,2, Ioachimescu OC. The intersection of obstructive lung disease and sleep apnea. Cleve Clin J Med. 2016 Feb;83(2):127-40.
18. Madama D, Silva A, Matos MJ. Overlap syndrome--Asthma and obstructive sleep apnea. Rev Port Pneumol (2006). 2016 JanFeb;22(1):6-10
19. Ciftci TU, Ciftci B, Guven SF, Kokturk O, Turktas H. Effect of nasal continuous positive airway pressure in uncontrolled nocturnal asthmatic patients with obstructive sleep apnea syndrome. Respir Med. 2005 May;99(5):529-34.
20. Julien JY, Martin JG, Ernst P, Olivenstein R, Hamid Q, Lemière C, et al. Prevalence of obstructive sleep apnea-hypopnea in severe versus moderate asthma. J Allergy Clin Immunol. 2009 Aug;124(2):371-6.
21. Wang TY, Lo YL, Lee KY, Liu WT, Lin SM, Lin TY, et al. Nocturnal CPAP improves walking capacity in COPD patients with obstructive sleep apnoea. Respir Res. 2013 Jun 19;14:66.