CPAP for COPD (and sleep apnea)

CPAP for COPD – much like CPAP for sleep apnea – is a treatment accepted by a large number of medical practitioners, as supported by a growing body of clinical research. But does using CPAP for COPD help improve the condition? And what’s the connection, if any, between COPD and sleep apnea?

Let’s back up a bit, and review exactly what CPAP is. A form of “positive airway pressure,” CPAP is a means of helping people with respiratory conditions breathe more easily.

CPAP stands for “continuous positive airway pressure,” in which air is delivered at a continuous rate to patients. And, as we discussed last month, there are a number of other different types of PAP treatments, such as CPAP, VPAP and APAP, and bi-level. But CPAP remains, by far, the most widely prescribed and used.

Using CPAP for COPD

Also as we discussed last month, PAP/CPAP therapy is used for more than treating sleep apnea (although that’s our focus). For example, CPAP for COPD and related respiratory conditions is also sometimes prescribed.

Short for chronic obstructive pulmonary disease, COPD is a condition affecting the lungs, making it difficult to breathe. It’s a category of conditions that includes such respiratory disorders as emphysema. It’s also progressive, meaning that it gets worse with time. It’s often, but not always, caused by smoking.

Since CPAP is a means to help people breathe, it stands to reason that CPAP for COPD would be an accepted treatment solution. Studies have supported this: In 2008, a study in Respirology  found that “CPAP can increase inspiratory capacity in patients with stable COPD, especially in those with emphysema.”¹ (“Inspiratory capacity” is clinical language for a person’s ability to inhale.)

A 2006 study published in the International Journal of Chronic Obstructive Pulmonary Disease also concluded that CPAP “was associated with significantly reduced rates of intubation … in COPD patients with acute respiratory failure.”² Intubation means inserting a tube into someone’s throat to assist breathing; this study found that using CPAP for COPD patients helps avoid the need for that.

“In these patients,” the study added, “mask CPAP may be a useful alternative mode of non-invasive respiratory assistance.”

COPD and sleep apnea

Beyond the use of CPAP, is there a further connection between COPD and sleep apnea?

According to a 2008 study published in the journal Proceedings of the American Thoracic Society, there’s some overlap between these two breathing-related conditions, but not much more than that.

The study found that sleep apnea-like disorders (called by the researchers “sleep apnea-hypopnea syndrome (SAHS)”) have a lot in common with COPD, such as the fact that they generally affect adults over 40 years of age. But only 0.5 percent of that population has both conditions, and that’s generally considered to be a result of chance, not a real clinical linkage.³

Actually, studies on COPD and sleep apnea commonly point to the need to use CPAP for COPD treatment. A 2010 study published in the American Journal of Respiratory and Critical Care Medicine states that overlap between COPD and sleep apnea “is associated with an increased risk of … hospitalization,” then concludes: “CPAP treatment was associated with improved survival and decreased hospitalizations in patients with overlap syndrome.”⁴

Some medical equipment providers offer special equipment designed to meet the needs of CPAP for COPD. For example, Resmed Stellar Series ventilators are also approved for COPD treatment and ideal for home-based therapy, particularly when used with the portable Resmed Power Station II.

This blog post contains general information about medical conditions and potential treatments. It is not medical advice. If you have any medical questions, please consult your doctor.

References

1. Source: Soares SM, Oliveira RA, Franca SA, Rezende SM, Dragosavac D, Kacmarek RM, Carvalho CR. “Continuous positive airway pressure increases inspiratory capacity of COPD patients.” Respirology. 2008 May;13(3):387-93. doi: 10.1111/j.1440-1843.2008.01263.x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18399861/ (accessed February 5, 2014).
2. Source: Sandra Dial, Dick Menzies. “Is there a role for mask continuous positive airway pressure in acute respiratory failure due to COPD? Lessons from a retrospective audit of 3 different cohorts.” Int J Chron Obstruct Pulmon Dis. 2006 March; 1(1): 65–72. Published online 2006 March. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC2706602/ (accessed February 5, 2014).
3. Source: Weitzenblum E, Chaouat A, Kessler R, Canuet M. “Overlap syndrome: obstructive sleep apnea in patients with chronic obstructive pulmonary disease.” Proc Am Thorac Soc. 2008 Feb 15;5(2):237-41. doi: 10.1513/pats.200706-077MG. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18250217/ (accessed February 5, 2014).
4. Source: Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR. “Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome.” Am J Respir Crit Care Med. 2010 Aug 1;182(3):325-31. doi: 10.1164/rccm.200912-1869OC. Epub 2010 Apr 8. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20378728/ (accessed February 5, 2014).