Sleep Apnea Risk in Subjects With Asthma With or Without Comorbid Rhinitis

Braido, Fulvio; Baiardini, Ilaria; Lacedonia, Donato; Facchini, Fabrizio; Fanfulla, Francesco; Molinengo, Giorgia; Canonica, Giorgio Walter

doi:10.4187/respcare.03084

Cited by 25 publications

(13 citation statements)

References 29 publications

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“…First, shared risks and comorbid conditions, such as GERD, rhinitis, and obesity, could play a very important role [13–16]. For example, Braido F et al reported that 52.6% (1021/1941) of asthma subjects had OSA, including 47.3% (350/740) with asthma alone and 55.9% (671/1201) with asthma and allergic rhinitis [16]. In the present study, we also noticed strong combined effects of these comorbidities and asthma on the risk of OSA, particularly those with GERD (adjusted HR: 11.4) and with obesity (adjusted HR: 6.07).…”

Section: Discussionmentioning

confidence: 99%

Risk of Obstructive Sleep Apnea in Adult Patients with Asthma: A Population-Based Cohort Study in Taiwan

et al. 2015

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BackgroundThere are several publications reported that obstructive sleep apnea (OSA) was associated with asthma. However, large-scaled, population-based cohort study has been limited. We aimed to examine the risk of OSA among adult patients with asthma in an Asian population.MethodsWe conducted a retrospective cohort study using data from the National Health Insurance (NHI) of Taiwan. The asthma cohort included 38,840 newly diagnosed patients between 2000 and 2010. The date of diagnosis was defined as the index date. Each patient was randomly matched with four people without asthma according to gender, age, and the index year as the comparison cohort. The occurrence of OSA was followed up until the end of 2011. The risk of OSA was estimated using the Cox proportional hazard model after adjusting for gender, age, and comorbidities.ResultsThe overall incidence of OSA was 2.51-fold greater in the asthma cohort than in the comparison cohort (12.1 versus 4.84 per 1000 person-years). Compared to non-asthma subjects, the adjusted hazard ratio (aHR) of OSA increased to 1.78 for asthma patients with one or less annual emergency room (ER) visit, and 23.8 for those who visited ER more than once per year. In addition, aHR in patients with inhaled steroid treatment compared to those without steroid treatment was 1.33 (95% CI = 1.01–1.76).ConclusionPatients with asthma have a significantly higher risk of developing OSA than the general population. The results suggest that the risk of OSA is proportional to asthma control and patients with inhaled steroid treatment have a higher risk for OSA than those without steroid treatment.

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Section: Discussionmentioning

confidence: 99%

Risk of Obstructive Sleep Apnea in Adult Patients with Asthma: A Population-Based Cohort Study in Taiwan

et al. 2015

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“…The present study showed that snoring was associated with local airway symptoms, such as wheezing and expectoration. The airway runs from the nose, through the throat, trachea and bronchus to the bronchioles, and each part of this structure has associated airway disorders, such as sinusitis/rhinitis, asthma and OSA, [16][17][18][19][20] giving rise to the concepts of "one airway, one disease", 21 "the atopic march", 17 and "the overlap syndrome of asthma and OSA". 22,23 These concepts were confirmed by various epidemiological studies, such as the Wisconsin Sleep Cohort Study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical impact of snoring in older community‐dwelling adults

Wada

Furuya

Maruyama

et al. 2019

Geriatrics Gerontology Int

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Aim The prevalence and clinical impact of snoring in the independent older adult population is unknown. To address this, we carried out this cross‐sectional epidemiological study of community‐dwelling independent older adults. Methods The study data were collected by the Japan Gerontological Evaluation Study 2013, a postal survey distributed to a large cohort of independent community‐dwelling older adults (aged ≥65 years) in 2013, across 30 municipalities of 14 prefectures. We used data for 24 837 participants (13 135 women, mean age 73.5 years, and 11 702 men, mean age 73.3 years). The association of snoring with airway symptoms and history of hypertension, diabetes and heart disease were investigated using Poisson regression models. Results The prevalence ratio (95% confidence intervals) for wheezing according to snoring frequency in men was 1.87 (1.45–2.43) among those who snored on 1–6 nights a week, and 2.95 (2.15–4.05) among those who snored every night. Similar relationships were observed for women. Expectoration, another airway symptom, was also associated with snoring frequency. Furthermore, snoring frequency was associated with a higher prevalence of hypertension, diabetes and heart disease. Both diabetes and heart disease were associated with snoring frequency in women independent of body mass index, but the association was only observed in men with a normal or lower body mass index. Conclusions Snoring is a highly prevalent and pathogenic symptom in adults aged ≥65 years. Geriatr Gerontol Int 2019; 19: 1165–1171.

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“…Both allergic and nonallergic rhinitis are independent risk factors for obstructive sleep apnoea, likely related to nasal congestion and reduced upper airway patency (Figure ) …”

Section: To What Degree Do Comorbidities Contribute To Difficult Asthma?mentioning

confidence: 99%

Comorbid “treatable traits” in difficult asthma: Current evidence and clinical evaluation

Tay

Hew

2017

Allergy

125

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The care of patients with difficult-to-control asthma ("difficult asthma") is challenging and costly. Despite high-intensity asthma treatment, these patients experience poor asthma control and face the greatest risk of asthma morbidity and mortality.Poor asthma control is often driven by severe asthma biology, which has appropriately been the focus of intense research and phenotype-driven therapies. However, it is increasingly apparent that extra-pulmonary comorbidities also contribute substantially to poor asthma control and a heightened disease burden. These comorbidities have been proposed as "treatable traits" in chronic airways disease, adding impetus to their evaluation and management in difficult asthma. In this review, eight major asthma-related comorbidities are discussed: rhinitis, chronic rhinosinusitis, gastroesophageal reflux, obstructive sleep apnoea, vocal cord dysfunction, obesity, dysfunctional breathing and anxiety/depression. We describe the prevalence, impact and treatment effects of these comorbidities in the difficult asthma population, emphasizing gaps in the current literature. We examine the associations between individual comorbidities and highlight the potential for comorbidity clusters to exert combined effects on asthma outcomes. We conclude by outlining a pragmatic clinical approach to assess comorbidities in difficult asthma.

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Sleep Apnea Risk in Subjects With Asthma With or Without Comorbid Rhinitis

Cited by 25 publications

References 29 publications

Risk of Obstructive Sleep Apnea in Adult Patients with Asthma: A Population-Based Cohort Study in Taiwan

Risk of Obstructive Sleep Apnea in Adult Patients with Asthma: A Population-Based Cohort Study in Taiwan

Prevalence and clinical impact of snoring in older community‐dwelling adults

Comorbid “treatable traits” in difficult asthma: Current evidence and clinical evaluation

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