General Practice Sleep Scale – Obstructive Sleep Apnea Questionnaire in Overlap Syndrome

A BSTRACT Background: Overlap syndromes, coexisting obstructive sleep apnea (OSA) with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), or bronchial asthma, are associated with increased morbidity and mortality. Polysomnography (PSG), the gold standard for diagnosing obstructive sleep apnea (OSA), is costly, time-consuming, and resource-intensive, highlighting the potential value of simple screening tools such as the General Practice Sleep Scale (GPSS) in primary care settings. Objectives: This study evaluates the utility of the GPSS-OSA questionnaire in a cohort of adults with OSA-related overlap syndromes attending a tertiary pulmonary medicine center in India. Materials and Methods: Ninety adults diagnosed with OSA-hypopnea syndrome (Apnea–Hypopnea Index ≥5 on overnight PSG) were retrospectively included. Anthropometric, spirometric, echocardiographic, lipid, and comorbidity data were recorded; GPSS scores were classified as low risk (0–7), moderate risk (8–13), and high risk (>13). Overlap syndromes (OSA-COPD, OSA-ILD, and OSA-bronchial asthma) and OSA syndrome (OSAS) severity (mild: 5–15, moderate: 15–30, and severe: ≥30 events/h) were systematically documented. Results: This was a prospective observational study of 90 patients, with a mean age of 53.81 ± 9.03 years; 64% were men, and the mean body mass index (BMI) was 32.95 ± 8.34 kg/m². Among the participants, 67% had OSA–COPD overlap, 27% had OSA–ILD overlap, and 6% had OSA–bronchial asthma overlap. Pulmonary hypertension was present in 98% (mean pulmonary artery systolic pressure: 42.88 mmHg), increasing with OSAS severity. The mean GPSS was 13.5% ± 3.68; 43% scored 8–13, 53% >13, and only 3% <7. High GPSS scores (>13) clustered with moderate and severe OSAS and overlap phenotypes, and GPSS consistently increased across OSA severity strata and overlap subgroups. Conclusion: GPSS scores were elevated and strongly associated with cases of overlap syndrome. These findings support GPSS as a practical, questionnaire-based screener to triage OSA risk in overlap syndrome patients, particularly in resource-limited healthcare systems.