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

Tsai Yu Wang, Yu-Lun Lo, Kang-Yun Lee, Wen Te Liu, Shu-min Lin, Ting Yu Lin, Yung Lun Ni, Chao Yung Wang, Shu Chuan Ho, Han-Ping Kuo*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

29 Scopus citations

Abstract

Background: 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.Methods: 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.Results: 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 < 0.05), and decreased urinary catecholamine levels, pre-exercise heart rate, oxygenation, and Borg scale in the overlap syndrome group. An improvement in the apnoea-hypopnoea index was an independent factor associated with the increase in walking distance (r = 0.564).Conclusion: Nocturnal CPAP may improve walking capacity in COPD patients with overlap syndrome.Trial registration: NCT00914264.

Original languageEnglish
Article number66
JournalRespiratory Research
Volume14
Issue number1
DOIs
StatePublished - 19 06 2013

Keywords

  • Autonomic dysfunction
  • Chronic obstructive pulmonary disease
  • Continuous positive airway pressure
  • Obstructive sleep apnoea
  • Walking capacity

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