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COPD-OSAHS overlap syndrome — SCE Respiratory MCQ

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HardSleep MedicineCOPD-OSAHS overlap syndromeSCE Respiratory

A 66-year-old man with moderate COPD has morning headaches and nocturnal choking despite mild daytime symptoms. BMI is 33 kg/m2. Spirometry shows FEV1 56% predicted and FEV1/FVC 0.58; overnight study shows OSAHS with prolonged nocturnal hypoxaemia and transcutaneous CO2 rise. What is the most appropriate ventilation strategy?

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Correct answer: A — Specialist assessment for CPAP or NIV depending nocturnal hypoventilation and daytime hypercapnia

COPD-OSAHS overlap with hypoventilation requires specialist sleep/ventilation assessment to choose CPAP or NIV according to hypercapnia and nocturnal hypoventilation. Oxygen alone can worsen CO2 retention and does not treat obstructive events. Invasive ventilation, mandibular device alone and inhaled steroids do not address the physiology adequately.

Reference: NICE NG202; BTS/ICS AHRF Guideline