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COPD-OSAHS overlap syndrome — SCE Respiratory MCQ

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HardSleep MedicineCOPD-OSAHS overlap syndromeSCE Respiratory

A 64-year-old man with severe COPD has persistent morning headaches and unrefreshing sleep despite optimal inhaled therapy. BMI is 31 kg/m2. ABG while stable shows PaCO2 6.9 kPa and sleep study shows OSAHS with nocturnal hypoventilation. What is the most appropriate ventilation strategy?

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Correct answer: E — Nocturnal NIV or CPAP pathway based on hypoventilation severity

COPD-OSAHS overlap with chronic hypercapnia and nocturnal hypoventilation needs specialist sleep/ventilation treatment, with CPAP or NIV selected according to hypoventilation severity. Oxygen alone may improve saturation while leaving obstructive events and hypoventilation untreated. Steroids, thrombolysis and pleurodesis do not address sleep-related ventilatory failure.

Reference: NICE NG202 OSAHS/OHS; BTS/ICS Ventilatory Management Guidance