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Page count: 152

Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) or Overlap syndrome has been shown to occur anywhere between 1-40% in population and clinic studies. Subjects with overlap syndrome are at increased risk of cardiovascular disease mortality than subjects with either condition alone. It has been hypothesized that hypoxic induced inflammation occurs in both conditions however research is limited as to the relationship between OSA and subclinical cardiovascular disease and the affect COPD has on this relationship. Several studies have looked at the association between OSA and COPD with conflicting results. A limitation to this research is defining COPD strictly by pulmonary function. Additionally there is inadequate research evaluating the relationship between OSA and subclinical atherosclerosis specifically examining the influence of various pulmonary abnormalities. The overall goal of the proposed research is to explore the pathway between OSA and subclinical atherosclerosis with measures of calcification from coronary and thoracic arteries and determine if these relationships are altered by pulmonary abnormalities. In addition, we evaluated the validity of self-reported OSA and the utility of Berlin sleep questionnaire in a COPD population. Multivariable regression analyses were utilized to evaluate these relationships. OSA was found to not be related to pulmonary function reduction (GOLD stages 2-4) or Emphysema however, there was a significant relationship with chronic bronchitis. In evaluating the association of OSA with calcification measures, we found a significant upward trend of prevalent OSA by increased severity of CAC (p