In Reply:
Alkhuja and colleagues remind us that CPAP treatment may be effective for treating depression seen in patients with COPD and obstructive sleep apnea (OSA): the overlap syndrome. These conditions are interrelated in that COPD and OSA are inflammatory conditions; depression can increase smoking, decrease medication adherence, and cause sleep disturbance; and poor sleep quality can worsen depression. Although CPAP treatment is not used for patients who have COPD alone, in persons with both COPD and depression it seems worthwhile to screen for OSA with a sleep study, as unrecognized OSA may contribute to the severity of the other conditions.
Footnotes
The authors have disclosed no conflicts of interest.
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