Association of Obstructive Sleep Apnea Risk With Asthma Control in Adults

Abstract

Background: Unrecognized obstructive sleep apnea (OSA) may lead to poor asthma control despite optimal therapy. Our objective was to evaluate the relationship between OSA risk and asthma control in adults. Methods: Patients with asthma seen routinely at tertiary-care clinic visits completed the validated Sleep Apnea Scale of the Sleep Disorders Questionnaire (SA-SDQ) and Asthma Control Questionnaire (ACQ). An ACQ score of Ն 1.5 defi ned not-well-controlled asthma, and an SA-SDQ score of Ն 36 for men and Ն 32 for women defi ned high OSA risk. Logistic regression was used to model associations of high OSA risk with not-well-controlled asthma (ACQ full version and short versions). Results: Among 472 subjects with asthma, the mean 6 SD ACQ (full version) score was 0.87 6 0.90, and 80 (17%) subjects were not well controlled. Mean SA-SDQ score was 27 6 7, and 109 (23%) subjects met the defi nition of high OSA risk. High OSA risk was associated, on average, with 2.87-times higher odds for not-well-controlled asthma (ACQ full version) (95% CI, 1.54-5.32; P 5 .0009) after adjusting for obesity and other factors known to worsen asthma control. Similar independent associations were seen when using the short ACQ versions. Conclusions: High OSA risk is signifi cantly associated with not-well-controlled asthma independent of known asthma aggravators and regardless of the ACQ version used. Patients who have diffi culty achieving adequate asthma control should be screened for OSA.CHEST 2010; 138(3):543-550Abbreviations: ACQ 5 Asthma Control Questionnaire; CPAP 5 continuous positive airway pressure; GERD 5 gastroesophageal refl ux disease; OSA 5 obstructive sleep apnea; PEFR 5 peak expiratory fl ow rate; PSG 5 polysomnography; SA-SDQ 5 Sleep Apnea Scale of the Sleep Disorders Questionnaire

Asthma-related comorbidities

“…Review also showed that a high probability of having OSA was associated with uncontrolled asthma and suggested that patients who have difficulty achieving adequate asthma control should be screened for OSA [117]. This group looked at 472 patients with asthma seen routinely at tertiary-care clinic visits, and who completed the Sleep Apnea Scale of the Sleep Disorders Questionnaire and the Asthma Control Questionnaire.…”

Asthma outcomes improve with continuous positive airway pressure for obstructive sleep apnea

“…OSAS is an important risk factor for uncontrolled asthma and for frequent exacerbations 7, 8, 9, 10, 11. In a prospective study of 22 patients with difficult‐to‐control asthma, a night polysomnography showed that all but one patient had OSAS (95.5% prevalence) 7.…”

Compromiso multisistémico en apnea obstructiva del sueño

“…Las alteraciones del sueño, así como la obesidad y RGE son factores de riesgo asociado a un mal control del asma 58 . En un estudio evaluaron la relación entre SAOS y control del asma, usando como metodología la aplicación del cuestionario "Sleep apnea scale of the sleep disorders questionnarie" (SA-SDQ) y el cuestionario "Asthma control questionnaire" (ACQ) junto a variables clínicas como: sexo, obesidad, RGE, alteraciones nasales y condiciones psiquiátricas encontrando que los pacientes con SAOS severos están asociados de forma independiente con un mal control del asma con un OR de 2,87 (IC 1,54-5,32) 59 . Como conclusión, existe evidencia clínica y experimental respecto a la asociación entre SAOS y múltiples patologías.…”