الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Overlap syndrome is known as the coexistence of chronic
obstructive pulmonary disease (COPD) and obstructive sleep apnea
(OSA), was first defined by flenley. Although it can refer to
concomitant occurrence of any of the pulmonary diseases and
OSA,but overlap syndrome is commonly considered as the
coexistence of OSA and COPD. This disease has unique adverse
health consequences distinct from each alone. Given the high
prevalence of each solitary disease, overlap syndrome is also likely to
be common and clinically relevant.(10)
Tri-level adaptive servo ventilation (Tri-level ASV) therapy is a
new method of ventilator support that was proposed to improve
breathing during the cyclic breathing phases by providing anticyclic
pressure support.(156)
Trilevel positive airway pressure uses three different pressure
levels over the course of the breathing cycle. The inspiratory positive
airway pressure (IPAP) pressure provides the inspiratory push and
ventilation. Expiratory pressure is varied between a lower level at the
start of expiration (expiratory positive airway pressure) and a higher
level at the end of expiration (end-expiratory positive airway pressure)
to provide a splint for airway.(101)
The aim of this study is to asses different non-Invasive methods
of positive airway pressure including CPAP, Bi-PAP and Tri-PAP in
the management of patients with overlap syndrome.
This prospective interventional clinical study was carried out on
45 patients diagnosed as overlap syndrome recruited from the outpatient
chest clinic or who were admitted at Chest department, Menoufia University Hospitals in the period between January 2019 to
September 2019. Patients were divided to three equal numbers and
comparable groups in whom CPAP, BiPAP and TriPAP was applied.