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已发表论文
重叠综合征（COPD-OSA）的诊断与管理：证据、挑战和前景
Authors Wei X, Zhang X, Wang S, Tong X , Wu C, Hu S, Shi L
Received 15 August 2025
Accepted for publication 15 December 2025
Published 17 January 2026 Volume 2026:18 560579
DOI https://doi.org/10.2147/NSS.S560579
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Marco Veneruso
Xiaotong Wei,1 Xiaoyu Zhang,2 Siping Wang,1 Xin Tong,3 Chuang Wu,1 Shaodan Hu,2 Li Shi2
1College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, People’s Republic of China; 2Department of Pneumology, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, People’s Republic of China; 3College of Integrated Traditional Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, People’s Republic of China
Correspondence: Li Shi, Department of Pneumology, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, People’s Republic of China, Email shili0648@163.com Shaodan Hu, Department of Pneumology, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, People’s Republic of China, Email 734168300@qq.com
Abstract: The overlap syndrome (OVS), characterized by the co-existence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), presents a significant clinical challenge due to its association with serious cardiopulmonary consequences and increased mortality. The complex pathophysiology and absence of standardized treatments often lead to underdiagnosis, aggravating its disease burden. Therefore, early and precise diagnosis is crucial. Beyond monitoring carbon dioxide levels as a key indicator of ventilatory limitation, a comprehensive diagnostic approach should integrate subjective assessments and objective examinations. Advances in precision medicine are shifting research focus towards biomarkers, including systemic inflammation ratios and vascular injury markers, to facilitate early detection and risk stratification. In terms of treatment, non-invasive ventilation (NIV) remains the cornerstone for maintaining airway patency, though its effectiveness is constrained by suboptimal adherence and inherent limitations. This has prompted the exploration of pharmacological strategies as alternatives or adjuncts, yet their application requires careful risk-benefit evaluation. For instance, benzodiazepines may worsen upper airway muscle tone and blunt hypercapnic arousal responses. Promising directions include novel pharmacotherapies inspired by recent advances in OSA treatment, alongside weight-loss agents that act through weight management and metabolic regulation. Adjunctive strategies such as mild intermittent hypoxia (IH) conditioning are being investigated to enhance positive airway pressure (PAP) therapy, while targeted agents like thioredoxin (TRX) demonstrate potential by mitigating oxidative stress and neutrophilic inflammation. However, the clinical translation of these innovations faces a major bottleneck the scarcity of large-scale randomized controlled trials (RCTs) to confirm their efficacy and safety. This review synthesizes current evidence to address these gaps and inform the future precision management of OVS.
Keywords: obstructive sleep apnea, chronic obstructive pulmonary disease, overlap syndrome, interventions, potential markers
1College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, People’s Republic of China; 2Department of Pneumology, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, People’s Republic of China; 3College of Integrated Traditional Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, People’s Republic of China
Correspondence: Li Shi, Department of Pneumology, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, People’s Republic of China, Email shili0648@163.com Shaodan Hu, Department of Pneumology, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, People’s Republic of China, Email 734168300@qq.com
Abstract: The overlap syndrome (OVS), characterized by the co-existence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), presents a significant clinical challenge due to its association with serious cardiopulmonary consequences and increased mortality. The complex pathophysiology and absence of standardized treatments often lead to underdiagnosis, aggravating its disease burden. Therefore, early and precise diagnosis is crucial. Beyond monitoring carbon dioxide levels as a key indicator of ventilatory limitation, a comprehensive diagnostic approach should integrate subjective assessments and objective examinations. Advances in precision medicine are shifting research focus towards biomarkers, including systemic inflammation ratios and vascular injury markers, to facilitate early detection and risk stratification. In terms of treatment, non-invasive ventilation (NIV) remains the cornerstone for maintaining airway patency, though its effectiveness is constrained by suboptimal adherence and inherent limitations. This has prompted the exploration of pharmacological strategies as alternatives or adjuncts, yet their application requires careful risk-benefit evaluation. For instance, benzodiazepines may worsen upper airway muscle tone and blunt hypercapnic arousal responses. Promising directions include novel pharmacotherapies inspired by recent advances in OSA treatment, alongside weight-loss agents that act through weight management and metabolic regulation. Adjunctive strategies such as mild intermittent hypoxia (IH) conditioning are being investigated to enhance positive airway pressure (PAP) therapy, while targeted agents like thioredoxin (TRX) demonstrate potential by mitigating oxidative stress and neutrophilic inflammation. However, the clinical translation of these innovations faces a major bottleneck the scarcity of large-scale randomized controlled trials (RCTs) to confirm their efficacy and safety. This review synthesizes current evidence to address these gaps and inform the future precision management of OVS.
Keywords: obstructive sleep apnea, chronic obstructive pulmonary disease, overlap syndrome, interventions, potential markers