Evaluation of sleep-related breathing disorders in COPD

OSA: obstructive sleep apnea; COPD: chronic obstructive pulmonary disease; HSAT: home sleep apnea test; GOLD: Global Initiative for Chronic Obstructive Lung Disease; SpO₂: pulse oxygen saturation; NREM/REM: nonrapid eye movement/rapid eye movement; PaCO₂: arterial partial pressure of carbon dioxide; PSG: polysomnography; AHI: apnea-hypopnea index; CPAP: continuous-positive airway pressure; APAP: auto(titrating)-positive airway pressure; PAP: positive airway pressure; SRBD: sleep-related breathing disorders; BPAP: bilevel-positive airway pressure; ASV: adaptive servo-ventilation.
* Most of the conditions that make HSAT not appropriate are also reasons for a full-night PSG study.
¶ These conditions increase the likelihood of nonobstructive sleep-disordered breathing, which is not adequately evaluated on HSAT.
Δ For uncomplicated OSA, a split-night protocol is preferred, assuming moderate to severe OSA is noted during a minimum of two hours of recording AND at least three hours are available for CPAP titration.
◊ Refer to UpToDate content on sleep-related breathing disturbances and on initiation and titration of positive airway pressure.
§ Refer to UpToDate content on snoring, excessive daytime sleepiness.