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Association Between Asthma and Risk of Developing Obstructive Sleep Apnea | Journal Scan
Study Questions:
Is pre-existing asthma a risk to develop obstructive sleep apnea (OSA)?
Methods:
Participants were part of the Wisconsin Sleep Cohort, which is comprised of 1,521 randomly selected State employees, ages 30-60 years, in 1988. Every 4 years, participants undergo questionnaires and a sleep study. Analysis for this study ended in 2013. To be included here, participants had to be free of OSA in the first two sleep studies. Incident OSA status was then determined on subsequent sleep studies. OSA was defined as: 1) developing apnea-hypopnea index (AHI) >5 or initiating treatment, or 2) developing AHI >5 with concomitant sleepiness. Asthma was self-reported physician diagnosis on at least two separate interviews. The final sample consisted of 547 subjects.
Results:
The average age was 50.4 ± 7.7 years old and 52% were women. Baseline body mass index was 28.9 ± 5.5 kg/m2 and 13% were current smokers. Asthma subjects had worse objective lung function findings on pulmonary testing compared to those without asthma. There were a total of 22/81 (27%) participants with asthma who developed OSA compared to 75/466 (16%) without asthma who developed OSA. The corresponding adjusted relative risk (RR) for an asthmatic developing OSA was 1.39 (95% confidence interval, 1.06-1.82), controlling for sex, age, baseline, and change in body mass index, and other factors.
Conclusions:
The authors concluded that asthma is a risk for developing OSA, and recommend periodic evaluation of OSA in this population.
Perspective:
More and more there is an observation of a bidirectional relationship of OSA to other common conditions encountered in today’s practice. Asthma and its comorbidities may alter airway passage patency during sleep, placing the individual at risk for OSA. Treatment of OSA improves asthma symptoms. Understanding the process of incident diagnosis of OSA among the asthma population is important to reduce quality-of-life burdens associated with both conditions.
Keywords: Apnea, Asthma, Body Mass Index, Comorbidity, Confidence Intervals, Cost of Illness, Polysomnography, Sleep, Sleep Stages, Sleep Apnea, Obstructive
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