Nocturnal asthma: snoring, small pharynx and nasal CPAP

Guilleminault, Christian; Quera-Salva, Maria-Antonia; Nb, Powell; Riley, R. Pp. – .; Romaker, A; Partinen, M; Baldwin, Roger B.; Niño-Murcia, German

doi:10.1183/09031936.93.01100902

Cited by 99 publications

(4 citation statements)

References 13 publications

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“…Upper airway closure and snoring could trigger vagally mediated bronchoconstriction 30,66 and worsen AHR, for example, by altering chemical arousal threshold or to resistive loading. 30 An additional postulated trigger for reflex bronchoconstriction is stimulation of the carotid body by the accompanying hypoxia. 67…”

Section: Neural Reflex Theorymentioning

confidence: 99%

“…The cessation of CPAP returned flow rates to levels before therapy. Guilleminault et al 30 studied 10 men with OSA and predominantly nocturnal asthma; more than 6 months of CPAP therapy abolished nocturnal asthma attacks. Five subjects with both daytime and nighttime asthma symptoms had regular snoring and more negative inspiratory esophageal pressures during sleep (indicative of increased upper airway resistance).…”

Section: Epidemiologymentioning

confidence: 99%

“…Positive airway pressure (mainly CPAP) therapy for OSA syndrome has been shown to improve asthmatic symptoms in patients with both conditions, 28,30-32 pulmonary function tests, 28,34,35 and disease-related quality of life. 32 Nevertheless, these benefits still await definitive confirmation in larger studies.…”

Section: Epidemiologymentioning

confidence: 99%

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Asthma and Obstructive Sleep Apnea: Clinical and Pathogenic Interactions

Puthalapattu

Ioachimescu

2014

Journal of Investigative Medicine

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Asthma and obstructive sleep apnea (OSA) are among the most prevalent chronic human diseases of the 21st century. They share several risk and aggravating factors such as obesity, smoking, gastroesophageal reflux, sinonasal disease or upper airway involvement, systemic inflammation, etc. Although the association between OSA and chronic obstructive pulmonary disease or "overlap syndrome" is better known and characterized, the association of asthma and OSA or "alternative overlap syndrome" is less clearly defined and understood. Nevertheless, their coexistence has synergistic effects on patient symptoms, response to therapy, and general outcomes. Taxonomically, asthma and OSA are syndromically defined entities that are quite heterogeneous, being characterized by a plethora of clinical phenotypes. The complex interactions between these conditions should take into account more specific etiopathogenic mechanisms or distinct disease endotypes. The potential clinical, pathogenic, and therapeutic significance of the disease endotypes is still emerging and needs further evaluation. We present here a review on the bidirectional relationships between asthma and OSA, including their clinical, pathophysiologic, and therapeutic connections. Furthermore, we propose here to look at these interactions beyond the development of comprehensive inventories of genotypes, clinical and pathophysiologic phenotypes, but in the larger context of obstructive lung and airway disorders, with the goal to reassess meaningful syndromes based on natural history and predictable patient outcomes, which will help us better stratify therapy in an era of personalized medicine.

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Section: Neural Reflex Theorymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Asthma and Obstructive Sleep Apnea: Clinical and Pathogenic Interactions

Puthalapattu

Ioachimescu

2014

Journal of Investigative Medicine

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“…Nocturnal airway narrowing results in poor sleep quality (6]. It has recently been reported that both snoring and sleep apnoea may precipitate nocturnal airway narrowing in asthmatics (7,8], but the prevalence of snoring and sleep apnoea in asthmatics is unknown. We have, therefore, also examined the fre-Methods A 15 page questionnaire, consisting of 92 questions, was sent by mail to 500 subjects at each of the following eight locations: Lerwick, Thurso, Aberdeen, Ayr, Leeds, Coventry, Southampton and St Helier.…”

mentioning

confidence: 99%

Snoring, asthma and sleep disturbance in Britain: a community-based survey

Fitzpatrick¹,

Martin²,

Fossey³

et al. 1993

Eur Respir J

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A questionnaire was sent to a random sample of adults in eight locations throughout Britain, to investigate the prevalence of snoring, asthma and sleep complaints in community-based British adult. Of the 1,478 respondents (831 females, 647 males; mean +/- SD age 45 +/- 18 yrs), 37% reported snoring at least occasionally, and 11% reported snoring on at least four nights per week (frequent snorers). Frequent snorers reported spending less time asleep at night, falling asleep accidentally during the day more often, taking planned daytime naps, and falling asleep whilst driving or operating machinery more often than the other respondent. Using ordinal logistic regression analysis to allow for the age and sex of the respondents, both accidental daytime sleep and planned daytime naps were commoner in frequent snorers than other respondents. Six percent of all respondents and 6% of those aged under 40 yrs reported that they had asthma (asthmatics). Seven percent of respondents aged less than 40 yrs reported wheezing on three or more occasions per year, and had been prescribed oral or inhaled bronchodilators (young wheezers). More than 80% of the asthmatic respondents of all ages, and young wheezers, reported waking at night with wheeze at least occasionally, and more than 30% of each group reported this symptom frequently. A larger proportion of asthmatics and young wheezers reported that their night-time sleep was unrefreshing, and that they had too little sleep at night than the other respondents.(ABSTRACT TRUNCATED AT 250 WORDS)

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