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Vol. 45. Issue S4.
EPOC y comorbilidad: una visión global
Pages 54-58 (March 2009)
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Vol. 45. Issue S4.
EPOC y comorbilidad: una visión global
Pages 54-58 (March 2009)
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EPOC y síndrome de apnea-hipopnea del sueño
COPD and sleep apnea-hypopnea syndrome
Visits
...
José María Marína,??
Corresponding author
jmmarint@unizar.es

Autor para correspondencia.
, Ana Boldovab
a Servicio de Neumología, Hospital Universitario Miguel Servet, Zaragoza, España
b MIR Neumología, Hospital Universitario Miguel Servet, Zaragoza, España
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Resumen

Se ha dado en llamar síndrome de overlap a la coexistencia en un mismo paciente con enfermedad pulmonar obstructiva crónica (EPOC) de apnea-hipopnea obstructiva durante el sueño. La prevalencia de esta entidad se calcula en un 1% de la población adulta. Sin que haya una presentación clínica característica, los pacientes con overlap presentan una EPOC con un grado desproporcionado de hipoxemia, hipercapnia y disnea. Suelen referir roncopatía, mala calidad de sueño y somnolencia diurna. Hay una rápida tendencia a desarrollar hipertensión pulmonar. La historia natural del proceso es poco conocida, pero del estudio de Cohorte Observacional del Sueño de Zaragoza se deduce un aumento de mortalidad secundaria a episodios cardiovasculares a largo plazo en pacientes no tratados con ventilación no-invasiva. El tratamiento del síndrome de overlap es el propio de los 2 componentes y, por tanto, debe optimizarse el tratamiento individualizado de la EPOC y evaluar la gravedad del trastorno respiratorio del sueño y su respuesta al tratamiento específico con ventilación no invasiva.

Palabras clave:
EPOC
Síndrome de apnea-hipopnea durante el sueño
Hipertensión pulmonar
Ventilación no invasiva
Abstract

Overlap syndrome refers to the coexistence of COPD and obstructive sleep apneas-hypopneas in the same patient. This syndrome affects 1% of the adult population. There is no particular clinical presentation but patients with overlap syndrome show COPD with disproportionate hypercapnia, hypoxemia and dyspnea. These patients usually report loud snoring, poor quality of sleep and daytime drowsiness. There is also a tendency to rapidly develop pulmonary hypertension. The natural history of the syndrome is largely unknown but some preliminary results from the Zaragoza Sleep Cohort Study indicate a high probability of long-term cardiovascular mortality in patients with overlap syndrome not treated with non-invasive ventilation. Treatment of the syndrome is nonspecific. The treatment of overlap syndrome is specific to each of the two components and consequently the management of COPD should be individually tailored and the severity of obstructive sleep apnea-hypopnea syndrome and response to non-invasive ventilation should be evaluated.

Key words:
COPD
Obstructive sleep apnea-hypopnea syndrome
Pulmonary hypertension
Non-invasive ventilation
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Copyright © 2009. Sociedad Española de Neumología y Cirugía Torácica
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