To investigate the sleep quality of elderly patients with overlap syndrome (OS) of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA).

166 elderly patients admitted to Zhejiang Hospital from February 2018 to February 2019 were selected, including 45 COPD patients (COPD group), 45 OSA patients (OSA group), 48 OS patients (OS group), and 28 healthy volunteers in the same period (healthy control group). The clinical data of all subjects were collected, Pittsburgh sleep quality index scale and polysomnography (PSG) were used to evaluate subjective and objective sleep quality. Univariate analysis of variance and rank sum test were used for comparison among multiple groups, LSD-t test and Bonferroni method were used for pairwise comparison, and counting data were compared by χ² inspection.

There were significant differences in BMI, neck circumference, ESS score, percentage of forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity (FVC) among the four groups (F=5.693, 12.804, 4.805, 195.050, 452.290, P < 0.01). The BMI of OS group and OSA group was significantly higher than that of healthy control group (P < 0.05), and the BMI of OS group was significantly higher than that of COPD group (P < 0.05). The neck circumference of OS group and OSA group was significantly higher than that of healthy control group and COPD group (P < 0.05). The ESS score of OS group and OSA group was significantly higher than that of healthy control group (P < 0.05), and the ESS score of OSA group was significantly higher than that of COPD group (P < 0.05). The FEV1% and FEV1/FVC in OS group and COPD group were significantly higher than those in healthy control group and OSA group (P < 0.05). There were significant differences in PSG monitoring indexes among the four groups (F=806.326, 59.965, 8.916, 24.168, 81.969, 15.666, P < 0.01). The apnea hypopnea index and the longest apnea time in OS group and OSA group were significantly higher than those in healthy control group and COPD group (P < 0.05). The apnea hypopnea index and the longest apnea time in OS group were significantly higher than those in OSA group (P < 0.05). The micro arousal index, mean blood oxygen saturation, minimum blood oxygen saturation and the percentage of blood oxygen saturation < 90% in the total monitoring time in OS group were significantly higher than those in other groups (P < 0.05). There were significant differences in other indexes except subjective total sleep time and objective sleep latency among the four groups (F=5.196, 6.470, 10.444, 6.785, 2.947, 8.591, 7.452, P < 0.05 or 0.01). The total time of subjective awakening and objective awakening after falling asleep in OS group, OSA group and COPD group were significantly higher than those in healthy control group (P < 0.05), and the subjective sleep efficiency, objective total sleep time and objective sleep efficiency were significantly lower than those in healthy control group (P<0.05).

There is a significant decline in sleep quality in elderly patients with COPD and OSA overlap syndrome, which may be the cause and effect of sleep quality, affecting the course of the disease.