Sleep disorders affect about one-third of people with chronic obstructive pulmonary disease (COPD). Some MyCOPDTeam members report sleeping only three or four hours per night. Others say they can sleep, but nothing helps them feel truly rested the next day.

“I’ve tried every sleep aid in the store. Nothing has worked for me, and I feel so tired in the morning,” shared one member.

Sleep issues in COPD could be due to a condition called obstructive sleep apnea (OSA). This condition affects up to 30 percent of people with COPD and can affect nighttime breathing and sleep quality. Keep reading to learn more about OSA and how you can manage it.

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Overlap Syndrome: Having COPD and OSA Together

If you have COPD and OSA at the same time, it’s called overlap syndrome. Both conditions cause breathing difficulty at night, which can greatly affect sleep quality and how you feel during the day.

In COPD, airway inflammation blocks airflow in and out of the lungs. Symptoms like mucus buildup, coughing, chest tightness, and shortness of breath can worsen over time and affect oxygen levels during the day or night.

Difficulty breathing at night with OSA can worsen COPD control (and vice versa) by further lowering oxygen levels. It can also increase the risk of heart problems.

What Are the Symptoms of Overlap Syndrome?

People with overlap syndrome have symptoms from both COPD and OSA. However, nighttime breathing problems and hypoxemia (low oxygen in the blood) can worsen daytime symptoms such as fatigue and headaches.

“I get bad headaches due to the lack of oxygen, and I doze off three times a day sometimes. It can be scary,” said one member recently diagnosed with overlap syndrome. Another member replied, “My dozing would get so bad that I’d do it eating or typing on the computer.”

Constant tiredness can greatly affect quality of life. It makes everyday activities such as walking, cooking, or going to the store more challenging. One member said they avoid going out in case they fall asleep in public.

Treatments for Overlap Syndrome

Treating overlap syndrome involves controlling both OSA and COPD to improve oxygen levels, sleep, and how you feel during the day. You and your doctor will work together to decide what’s best for you.

Changing Your Lifestyle

Building healthy habits can help reduce symptoms and prevent future health complications from overlap syndrome. Below are three lifestyle adjustments you can start doing now that have a big impact.

• Quitting smoking — Smoking is one of the biggest risk factors for COPD, OSA, and worsening overlap syndrome.
• Losing weight — Obesity and having a wide neck are risk factors for OSA.
• Exercising regularly — Structured exercise and pulmonary (lung) rehabilitation can improve sleep quality, daytime sleepiness, mood, and strength.

Several MyCOPDTeam members have shared lifestyle changes they have made. “Stopping smoking was one of the hardest things I’ve ever done, but I’m so happy to have stopped. My condition is much better for it,” shared one member.

Another wrote about their newfound love for exercise. “I’ve gotten into many activities like walking about three to five miles per day,” they wrote.

If you need support or aren’t sure where to start, talk to your doctor. They may refer you to other specialists or programs that can guide you in the right direction.

Sleeping With Positive Airway Pressure

Positive airway pressure (PAP) is typically the most appropriate therapy for overlap syndrome because it improves nighttime airflow, reduces snoring, and helps protect against complications. During PAP therapy, you sleep with a mask that delivers pressurized air into your airway to keep it open and improve oxygen flow.

There are different types of PAP therapy, and the right one depends on what most affects your nighttime oxygen levels.

• Continuous positive airway pressure (CPAP) — Often the first-line therapy, this type delivers a steady level of pressurized air that stays the same when you breathe in and out.
• Bilevel positive airway pressure (BiPAP) — This type delivers higher pressure when you breathe in and lower pressure when you breathe out to better support your lungs. It’s most appropriate for people with daytime hypercapnia (high carbon dioxide levels in the blood) who need more lung support.

Many MyCOPDTeam members use CPAP machines at home. “I had to practice using my CPAP before I got comfortable with it,” wrote one member. Another shared how much it’s helped them, stating, “I’ve used mine for 65 days now, and it’s made my life so much better because I’m refreshed, less breathless, and less anxious!”

Using Supplemental Oxygen

Supplemental oxygen helps control COPD and improve oxygen levels. People who use supplemental oxygen wear a nasal cannula (tube) that delivers oxygen in the nose, usually from a portable tank.

For some people who have COPD alone (without sleep apnea) and whose oxygen levels drop while they sleep, using extra oxygen at night can raise those oxygen levels. Certain studies have shown they may also help improve sleep quality.

For some people with OSA and COPD, using supplemental oxygen may even be harmful. Supplemental oxygen could worsen breath-holding episodes and blood carbon dioxide levels, so doctors prescribe it carefully alongside PAP or other treatments.

One member shared that they use combined therapies to help them sleep: “I use my CPAP machine at night. It’s also preset to give me oxygen through the mask.”

Talk to Your Healthcare Team

Ask your doctor about OSA and overlap syndrome if you have the following symptoms. They can assess your risk and refer you to a sleep specialist if appropriate.

• Unusual tiredness during the day
• Morning headaches
• Difficulty sleeping well
• Snoring or breath-holding, according to a sleep partner

Don’t wait to get evaluated and treated. Overlap syndrome increases your risk for serious health complications, including:

• Hypertension, or high blood pressure
• Pulmonary hypertension, or high blood pressure in the lungs
• Heart attack
• Blood flow issues, like peripheral artery disease
• Heart failure
• Hyperlipidemia, or high levels of fat in the blood
• Atrial fibrillation, or how the heart coordinates pumping blood

Overlap syndrome can also pose harm to others if you fall asleep behind the wheel, while babysitting small children, and in other high-risk situations.

Join the Conversation

On MyCOPDTeam, people share their experiences with COPD, get advice, and find support from others who understand.

Do you have sleep apnea? What helps you sleep better? Let others know in the comments below.