Harefuah
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Overlap syndrome is a term which specifies the existence of both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) in the same patient. The prevalence of OSA in COPD patients equals its prevalence in the general population. ⋯ They also have a greater prevalence of pulmonary hypertension and right heart failure, and suffer higher morbidity. Due to these consequences of the overlap syndrome, it is recommended to actively search for its existence in COPD patients, and to treat it with continuous positive airway pressure (CPAP) concurrently with oxygen and optimal pharmacological treatment of COPD.
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The aim of this study was to evaluate demographic and polysomnographic characteristics of positional (PPJ) and non-positional obstructive (NPP) sleep apnea (OSA) patients in 2077 OSA patients diagnosed in our Sleep Disorders Unit during a period of 10 years. An OSA patient is defined as positional if he has twice as many or more breathing abnormalities (apnea and hypopneas) while he sleeps in his supine posture compared to the lateral ones. Of the 2077 OSA patients, 1118 (53.8%) were positional and 959 (46.2%) were non-positional. ⋯ As AHI and BMI increase, the Likelihood to be a positional patient decreases. NPP have breathing abnormalities in the supine and lateral postures, thus, for them without question, CPAP is the treatment of choice. Since avoiding the supine posture during sleep may significantly improve the sleep quality and daytime alertness of many positional patients, it is imperative to carry out a high-quality study to evaluate if this is a real therapeutic alternative for many positional patients.