Asthma and Obstructive Sleep Apnea

Qiao, Yupu; Xiao, Yi

doi:10.4103/0366-6999.167361

Cited by 21 publications

(19 citation statements)

References 66 publications

(61 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Asthma is a common respiratory disorder with complex interactions between airflow obstruction, hyper-responsiveness, reversible expiratory flow limitation and inflammation 11 , whereas OSA is characterized by snoring and interruptions in breathing during sleep with symptoms such as brief paroxysmal nocturnal dyspnea, choking during sleep, and nocturia along with daytime sleep, depression and memory loss 12 , 13 .…”

Section: Introductionmentioning

confidence: 99%

Association of Obstructive Sleep Apnea with Asthma: A Meta-Analysis

Kong

Qin

Shen

et al. 2017

Sci Rep

111

View full text Add to dashboard Cite

This study evaluates the relationship between obstructive sleep apnea (OSA) and asthma. Literature search was carried out in several electronic databases and random effects meta-analyses were performed to obtain pooled estimates of the prevalence of OSA, OSA risk and sleep disordered breathing (SDB) in asthma patients and pooled odds ratios of the prevalence between asthma and non-asthma patients. In adult asthma patients, the prevalence [95% confidence interval] of OSA, OSA risk, and SDB was 49.50 [36.39, 62.60] %, 27.50 [19.31, 35.69] %, and 19.65 [14.84, 24.46] % respectively. The odds of having OSA, OS risk and SDB by the asthma patients were 2.64 [1.76, 3.52], 3.73 [2.90, 4.57] and 1.73 [1.11, 2.36] times higher (p < 0.00001 for all) in asthma than in non-asthma patients, respectively. Adult asthma patients with OSA had significantly higher BMI in comparison with asthma patients without OSA. This study reveals that the prevalence of OSA in asthma patients is considerably higher; even higher than OSA risk and SDB. Sleep studies should be performed in asthma patients with symptoms suggestive of OSA/OSA risk/SDB.

show abstract

Section: Introductionmentioning

confidence: 99%

Association of Obstructive Sleep Apnea with Asthma: A Meta-Analysis

Kong

Qin

Shen

et al. 2017

Sci Rep

111

View full text Add to dashboard Cite

show abstract

“…Exposure to CIH is thought to be responsible for the marked increase in sympathetic nerve activity and consequential hypertension. [ 37 38 39 40 ] In another study,[ 41 ] we reported that BP, after 21 days of CIH, was significantly higher than that of before CIH, the renal sympathetic activity was significantly enhanced, and the serum norepinephrine level was higher. These results indicate that CIH causes hypertension and overactivity of the sympathetic nervous system.…”

Section: Discussionmentioning

confidence: 92%

Establishment of a Rabbit Model of Chronic Obstructive Sleep Apnea and Application in Cardiovascular Consequences

Zhou

et al. 2017

Chinese Medical Journal

View full text Add to dashboard Cite

Background:Although obstructive sleep apnea (OSA) has been recognized as a major risk factor for cardiovascular complications and its clinical features are well characterized, it is difficult to replicate the OSA hypoxic model in humans. We aimed to establish an experimental rabbit model for chronic OSA and to explore its application to measure blood pressure (BP), myocardial systolic function, and oxidative stress.Methods:The rabbit model for OSA was established by repeatedly closing the airway and then reopening it. A tube specially designed with a bag that could be alternately inflated and deflated according to a predetermined time schedule, resulting in recurrent airway occlusions and chronic intermittent hypoxia (CIH) imitating OSA patterns in humans, was used. Twenty-four rabbits were randomly divided into obstruction, sham, and control groups, and their upper airways were alternately closed for 15 s and then reopened for 105 s in a 120-s-long cycle, for 8 h each day over 12 consecutive weeks. Before and after the experiment, the BP of each rabbit was monitored. Levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the serum, superoxide dismutase (SOD) activity, malondialdehyde (MDA) and reactive oxygen species (ROS) contents, as well as Na+-K+-ATPase/Ca2+-ATPase activities in cardiac muscle were examined. In addition, cardiac functional parameters were measured using echocardiography.Results:After 3 months, all rabbits in the obstruction group manifested sleepiness performance similar to that observed in OSA patients. Traces of airflow and SpO2 showed that this model mimicked the respiratory events involved in OSA, including increased respiratory effort and decreased oxygen saturation. Gradually, the BP rose each month. CIH led to obvious oxidative stress and injured myocardial systolic performance. The serum levels of IL-6 and TNF-α increased significantly (64.75 ± 9.05 pg/ml vs. 147.00 ± 19.24 pg/ml and 59.38 ± 8.21 pg/ml vs. 264.75 ± 25.54 pg/ml, respectively, both P < 0.001). Compared with the sham and the control groups, myocardial activities of Na+-K+-ATPase/Ca2+-ATPase and SOD in the obstruction group decreased markedly, while ROS and MDA content increased.Conclusions:These results show that the rabbit model for OSA simulates the pathophysiological characteristics of OSA in humans, which implies that this animal model is feasible and useful to study the mechanisms involved in the cardiovascular consequences of OSA.

show abstract

“…Similarly, recent animal and human studies have shown OSA could influence lower airway inflammation and remodeling [22]. Effects of OSA on asthma includes increasing vagal tone during apneic episodes triggering muscarinic receptors induced bronchoconstriction, intermittent hypoxic oxidative stress causing endothelial dysfunction, increased inflammation, Vascular Endothelial Growth Factor (VEGFhypoxia-sensitive glycoprotein which may contribute to bronchial inflammation), Leptin-related airway changes (pro-inflammatory effects), Sleep fragmentation (causing increased cholinergic outflow during REM sleep), GERD (asthma triggered form microaspirations and respiratory mucosal injury and reflex bronchospasm) and cardiac dysfunction (OSA leads to cardiac dysfunction and CHF itself has been known to worsen asthma) [23][24][25][26]. The majority of patients with asthma have rhinitis and nasal obstruction which causes changes in airway velocity and resistance promoting upper airway collapse and thus symptoms of SDB [27].…”

Section: Discussionmentioning

confidence: 99%

Polysomnographic variables in Alternate overlap syndrome: data from sleep heart health study

Shrestha

Mukhtar

Kandel

et al. 2019

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Objective: To evaluate influence of asthma on polysomnographic variables of patients with obstructive sleep apnea (OSA). Methods: A longitudinal retrospective study using data collected from the Sleep Heart Health Study (SHHS). Results: All 2822 patients included had OSA, 2599 were non-asthmatic whereas 223 were asthmatics. Average BMI for non-asthmatics was 28.8 kg/m 2 whereas asthmatics had 29.5 kg/ m 2 . Median pack-years of smoking was 1.42 vs. 1.98 in non-asthmatic and asthmatic groups, respectively. Sex distribution, age (in years), BMI, FEV 1 , FVC, AHI ≥ 4% (all apneas, hypopneas with ≥4% oxygen desaturation or arousal per hour of sleep), RDI ≥ 3% (overall respiratory distribution index at ≥3% oxygen desaturation or arousal), sleep latency, percentage of sleep time in apnea/hypopnea and Epworth sleep scale score were all statistically significant. Nonasthmatics had greater AHI (12.63/hr) compared to asthmatics (11.34/hour), p = 0.0015. RDI in non-asthmatics and asthmatics was (23.07 vs 20.53; p = 0.009). Sleep latency was found to be longer in asthmatics 19.8 minutes vs. 16 minutes (p = 0.008). Epworth sleepiness scale score was high in asthmatics (9 vs. 8, p = 0.002). Conclusion: OSA was found more severe in non-asthmatic subgroup, but asthmatics had statistically significant higher Epworth sleepiness scale score and sleep latency. Clinicians should be vigilant and keep low threshold to rule out OSA particularly on patients with difficult to control asthma, smoker, GERD, obese and nasal disease. ARTICLE HISTORY

show abstract

Asthma and Obstructive Sleep Apnea

Cited by 21 publications

References 66 publications

Association of Obstructive Sleep Apnea with Asthma: A Meta-Analysis

Association of Obstructive Sleep Apnea with Asthma: A Meta-Analysis

Establishment of a Rabbit Model of Chronic Obstructive Sleep Apnea and Application in Cardiovascular Consequences

Polysomnographic variables in Alternate overlap syndrome: data from sleep heart health study

Contact Info

Product

Resources

About