Research

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

Tsai-Yu Wang^1†, Yu-Lun Lo^1†, Kang-Yun Lee¹, Wen-Te Liu^2,3, Shu-Min Lin¹, Ting-Yu Lin¹,Yung-Lun Ni⁴, Chao-Yung Wang⁵, Shu-Chuan Ho^1,3 and Han-Pin Kuo^1*

• *Corresponding author: Han-Pin Kuo q8828@ms11.hinet.net
• † Equal contributors

Author Affiliations

¹Department of Thoracic Medicine, Chang Gung Memorial Hospital and Chang Gung University, School of Medicine, Taipei, Taiwan

²Division of Pulmonary, Department of Internal Medicine, Shuang Ho Hospital, Taipei, Taiwan

³School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan

⁴Department of Chest Medicine, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan

⁵Department of Cardiology Medicine, Chang Gung Memorial Hospital and Chang Gung University, School of Medicine, Taipei, Taiwan

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Respiratory Research 2013, 14:66 doi:10.1186/1465-9921-14-66

The electronic version of this article is the complete one and can be found online at:http://respiratory-research.com/content/14/1/66

Received:	11 February 2013
Accepted:	17 June 2013
Published:	19 June 2013

© 2013 Wang et al.; licensee BioMed Central Ltd. 

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

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Trial registration

NCT00914264

Keywords: 

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