Although they may have similar pathophysiological mechanisms, because OSA and COPD are common, even by chance alone, a substantial number of patients are afflicted by both OSA and COPD-the overlap syndrome. Nocturnal oxygen desaturation is the most important pathophysiological effect of overlap syndrome. The morbidity and mortality of overlap syndrome is greater than that of either disease alone. During evaluation of patients with either OSA or COPD, a high index of suspicion is crucial to detect the overlap syndrome. The presence of daytime hypercapnia and pulmonary hypertension, in patients having either disease, especially when mild in severity, should prompt assessment for the other disorder. Currently, CPAP with or without oxygen therapy is the treatment of choice for overlap syndrome.
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