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

Serrano-Pariente, José; Plaza, Vicente; Soriano, Joan B.; Mayos, Mercedes; López-Viña, Antolín; Picado, César; Vigil, Laura

doi:10.1111/all.13070

Cited by 79 publications

(68 citation statements)

References 43 publications

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“…Treatment of OSAS with CPAP improves asthma control . Short‐term CPAP treatment has been demonstrated to reduce airway hyperresponsiveness in asthma already after 7 days .…”

Section: Obstructive Sleep Apnoea Syndromementioning

confidence: 99%

Co‐morbidities in severe asthma: Clinical impact and management

2017

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Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD), bronchiectasis, allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatous with polyangiitis (EGPA). Furthermore, the review offers a summary of recommended diagnostic and management approaches for each co-morbidity. Finally, the review links co-morbid conditions to specific phenotypes of severe asthma, in order to guide the clinician on which co-morbidities to look for in specific patients.

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“…Treatment of OSAS with CPAP improves asthma control . Short‐term CPAP treatment has been demonstrated to reduce airway hyperresponsiveness in asthma already after 7 days .…”

Section: Obstructive Sleep Apnoea Syndromementioning

confidence: 99%

Co‐morbidities in severe asthma: Clinical impact and management

2017

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“…Although the effect has not been studied in difficult asthma per se, CPAP treatment may improve symptom control, lung function, as well as decrease exacerbation rates [148] and airway hyperresponsiveness in asthma in general [149]. …”

Section: Management Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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“…The AHI is significantly associated with the occurrence of severe asthma exacerbations (4). Researchers have found that long-term treatment of CPAP in patients with both asthma and obstructive sleep apnoea can decrease the asthma symptoms and improve asthma control and quality of life (9,10). Since evaluating OSA in patients with asthma has been included in the Guidelines for the Diagnosis and Management of Asthma (21), there is a need for clinical investigations of early and periodic detection of OSA among asthma populations.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiologic data showed that the prevalence of OSA among asthmatic populations ranges from 38% up to as high as 70% (7). There is growing evidence that continuous positive airway pressure (CPAP) in adults and adenotonsillectomy in children which are recommended as first line treatment of OSA can improve their asthma symptoms (8)(9)(10). Mild OSA in severe asthma patients is associated with increased proportion of neutrophils in sputum and changes in airway remodeling (11,12).…”

Section: Introductionmentioning

confidence: 99%

Screening for obstructive sleep apnea syndrome in asthma patients: a prospective study based on Berlin and STOP-Bang questionnaires

Lu¹,

Fu²,

Li³

et al. 2017

J. Thorac. Dis.

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Background: The bidirectional relationship of asthma and obstructive sleep apnea (OSA) has been confirmed in recent years. However, in the clinical practice, majority of asthma patients did not pay adequate attention to their sleep apnea condition. Berlin questionnaire (BQ) and STOP-Bang questionnaire (SBQ) are two most common OSA screening questionnaires to screen high-risk patients for OSA. This study aimed at evaluating the predictive performance of BQ and SBQ for OSA in asthma patients.Methods: Asthma outpatients of Zhongshan Hospital were enrolled into the study. All patients were asked to fill in the BQ and SBQ and clinical characteristics and asthma characteristics were recorded. Univariate and multivariate logistic regression analyses were applied to identify risk factors of OSA in asthma patients.With the gold standard of laboratory-based overnight polysomnography (PSG), the predictive performance of SBQ and BQ was evaluated and compared. The probability of OSA severity was predicted by various SBQ scores in asthma patients.Results: A total of 123 asthma patients (average age 47.56±12.12 years; 57.72% males) were enrolled and underwent PSG diagnosis overnight at Sleep Center. Logistic regression analyses showed that rhinitis (adjusted OR =4.30; 95% CI: 1.50-12.37, P=0.007) and dyslipidemia (adjusted OR =2.75; 95% CI: 1.16-6.51, P=0.021) were associated with OSA in asthma patients after adjusting for known OSA risk factors. No asthma functional characteristic differences were found to be associated with OSA severity in the study. The prevalence of moderate-to-severe OSA (AHI ≥15) in the asthmatic population sample was 36.59% (45/123).Questionnaires predictive results showed that compared with BQ, SBQ has higher diagnostic sensitivity (84.4% vs. 60%), lower specificity (79.5% vs. 91%) lower positive predictive value (PPV): (70.4% vs. 79.4%) and higher negative predictive value (NPV) (90% vs. 80%) to detect moderate-to-severe OSA at the cutoff as AHI of 15/h. OSA probability results showed that with the increasing of the questionnaire scores, the moderate and severe OSA probability of SBQ rose significantly.Conclusions: SBQ is a preferable sleep questionnaire better than BQ for detecting moderate and severe OSA in asthma patients which should be validated in larger population sample.

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

Cited by 79 publications

References 43 publications

Co‐morbidities in severe asthma: Clinical impact and management

Co‐morbidities in severe asthma: Clinical impact and management

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Screening for obstructive sleep apnea syndrome in asthma patients: a prospective study based on Berlin and STOP-Bang questionnaires

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