Overlap Syndrome: The Link Between COPD + Sleep Apnea

Combining these two breathing disorders can wreak havoc on sleep.

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On its own, chronic obstructive pulmonary disorder (COPD) can be challenging enough. This lung disease inhibits air sacs from absorbing oxygen properly, causing a sense of breathlessness. People with COPD often feel out of breath doing simple things, like walking out to the mailbox or going up a few stairs.

However, many people with COPD deal with an additional hurdle to their breathing: obstructive sleep apnea, a sleep disorder that affects over 18 million people in the United States. (Learn more about common sleep disorders here.) 

“Often times, sleep apnea and COPD can coexist together,” says Margarita Oks, MD, pulmonologist at Lenox Hill Hospital and Northwell Health. “There is an overlap syndrome that we’re now actually beginning to recognize and understand that there could be some groups that have a higher prevalence of both disorders occurring together.”

People with sleep apnea actually stop breathing periodically through the night. The pauses can last as long as 10 seconds, and then breathing often resumes with a gasp or snort. The halted breathing can occur due to collapsed muscles in the back of the throat (obstructive sleep apnea) or the brain not properly controlling breathing while sleeping (central sleep apnea). 

When you’re not getting the necessary oxygen while sleeping, your brain automatically wakes you up. As a result, people with sleep apnea often experience a reduced quality of sleep, resulting in drowsiness even after a full eight hours of sleep. (Here are other subtle signs of sleep apnea.)

“People who have COPD already have a lung problem,” says Dr. Oks. “It becomes even harder for them to breathe at night, so they can actually be more breathless and more fatigued overnight when they’re sleeping.”

The person with this “overlap syndrome” may not always realize they’re waking up or gasping for air. In many cases, this is noticed by their bed partner instead. For example, they may hear their partner snoring (with occasional pauses), or notice that their partner’s chest periodically stops rising and falling. 

While treatment depends on the type and severity of your sleep apnea, the most common treatment for sleep apnea is a CPAP machine, or continuous positive airway pressure machine. “This is a mask that’s attached to a machine that’s delivering pressure to the back of the airway and acts as a splint,” says Dr. Oks. 

Whether or not you have COPD, starting treatment for sleep apnea can have major benefits to your quality of life and overall health. “If you’re concerned about sleep apnea, ask your doctor,” says Dr. Oks. “Usually your doctor will refer you for further testing to diagnose any kind of sleep apnea."