Respiratory & Sleep Management
Volume 5 Number 7
September 2010
By Janis Rizzuto
Serving patients who need both PAP equipment and oxygen is a strong way to expand business. Are you doing enough to diagnose and treat this population?
The term “overlap syndrome” was coined in 1985 to describe patients who have both chronic obstructive pulmonary disease and obstructive sleep apnea. Since then, it has been recognized that the co-existence of COPD and OSA is associated with increased morbidity.
Estimates of the incidence of overlap syndrome depend on how one looks at it. The clinical literature suggests that about 10 percent of OSA patients have some degree of COPD, and between 20 percent to 40 percent of COPD patients have some degree of sleep-disordered breathing, according to Ann Tisthammer, BS, RRT, vice president of clinical education and training at ResMed, San Diego.
Either way, respiratory therapists report that they encounter overlap patients in their work for HME businesses, and that the population benefits from using two technologies, positive airway pressure devices and oxygen equipment. Ricky Hubbard, CRT, respiratory manager at Zurcare LLC in Ridgeland, Miss., says this group of patients is unique. “They tend to be more compliant with their treatment because their condition is more involved than a typical CPAP patient,” he says. “They realize there could be more consequences if they are not compliant, and the consequences may be more severe than if they were just an OSA patient.” Zurcare has a program to monitor compliance with regular data downloads and some wireless technology.
However, Hubbard says that only about 5 percent of Zurcare’s patients have overlap syndrome. He says they typically start out receiving sleep therapy, and then oxygen is added when desaturation is discovered via an overnight oximetry study. Few patients come onboard with orders for PAP and oxygen equipment at the same time, he says.
