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The following is a summary of “Triple overlap of COPD, severe obesity, and high risk of OSA: insights from an NHANES analysis,” published in the June 2025 issue of BMC Pulmonary Medicine by Orbell et al. 

Researchers conducted a retrospective study to examine the prevalence of triple overlap among adults living with chronic obstructive pulmonary disease (COPD), obesity, and at high risk for obstructive sleep apnea (OSA), and to identify associated sociodemographic factors using National Health and Nutrition Examination Survey (NHANES) data. 

They analyzed using NHANES data from 2005–2008 and 2015–March 2020. The COPD was identified through self-reported questionnaires. High risk for OSA (HR-OSA) was defined using a modified Multivariable Apnea Prediction (MAP) index. Severe obesity was classified as a body mass index (BMI) of ≥ 40.0 kg/m² 

The results showed that from 2005–2008 to 2015–March 2020, the proportion of individuals with a triple overlap of COPD, severe obesity, and HR-OSA rose from 0.653% [95% CI, 0.651–0.655%] to 1.560% [95% CI, 1.557–1.563%]. During this period, age-standardized prevalence of severe obesity increased from 6.298% [95% CI, 6.291–6.305%] to 8.943% [95% CI, 8.936–8.950%], and HR-OSA increased from 58.667% [95% CI, 58.646–58.688%] to 58.776% [95% CI, 58.758–58.794%], while COPD rose from 9.223% [95% CI, 9.215–9.231%] to 10.213% [95% CI, 10.206–10.220%]. Higher rates of triple overlap were observed among women and individuals with lower household incomes.  

Investigators concluded that the triple overlap among US adults with COPD, severe obesity, and high risk for OSA increased over 15 years, with notable sociodemographic disparities. 

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-025-03752-4