Does CPAP for obstructive sleep apnoea improve asthma control?

Hamilton, Garun S.

doi:10.1111/resp.13385

Cited by 5 publications

(8 citation statements)

References 14 publications

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“…In addition, some of 'nocturnal asthma' in those with OSA could be OSA symptoms that respond to OSA treatment. 30 While we did not look specifically at daytime asthma symptoms, our findings raise the possibility that OSA and nocturnal asthma symptoms may be confused in the general practice setting. Further investigation/evaluation may be useful for some individuals who have nocturnal symptoms unamenable to asthma treatment.…”

Section: Discussionmentioning

confidence: 80%

“…There could be a subset of patients where OSA is worsening asthma control, including in daytime. In addition, some of ‘nocturnal asthma’ in those with OSA could be OSA symptoms that respond to OSA treatment . While we did not look specifically at daytime asthma symptoms, our findings raise the possibility that OSA and nocturnal asthma symptoms may be confused in the general practice setting.…”

Section: Discussionmentioning

confidence: 81%

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Nocturnal symptoms perceived as asthma are associated with obstructive sleep apnoea risk, but not bronchial hyper‐reactivity

et al. 2019

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Background and objective Obstructive sleep apnoea (OSA) and asthma are associated, and nocturnal breathing difficulty that is usually identified as asthma‐like symptoms can be present in both conditions. We investigated how nocturnal asthma‐like symptoms (NAS) and bronchial hyper‐reactivity (BHR) contribute to the association between OSA risk and current asthma, which is currently unknown but a clinically important question. Methods We used data from 794 middle‐aged participants in a population‐based cohort who provided information on OSA risk (defined by a STOP‐Bang questionnaire score of at least 3), current asthma and NAS, and underwent methacholine bronchial challenge testing. Using regression models, we examined the association between OSA risk and current asthma‐NAS subgroups and investigated any effect modification by BHR. Results The participants were aged 50 years (49.8% male). OSA risk was associated with NAS with or without current asthma (odds ratio (OR): 2.6; 95% CI = 1.3–5.0; OR: 4.2; 95% CI = 1.1–16.1, respectively), but not with current asthma in the absence of NAS. BHR was associated with current asthma with or without NAS (OR: 2.9; 95% CI = 1.4–5.9; OR: 3.4; 95% CI = 2.0–7.0, respectively) but not with NAS in the absence of current asthma. The associations between OSA risk and current asthma were neither modified nor mediated by BHR. Conclusion Our findings suggest that some of the nocturnal symptoms perceived as asthma may be OSA symptoms. Patients with nocturnal asthma symptoms should be considered for possible OSA.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 81%

Nocturnal symptoms perceived as asthma are associated with obstructive sleep apnoea risk, but not bronchial hyper‐reactivity

et al. 2019

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“…For example, this current knowledge makes it difficult to theorize how maternal asthma would cause OSA in adult offspring. However, as OSA symptoms might be misconstrued as nocturnal asthma, 39 at least some of the maternal asthma could be maternal OSA and may indicate a familial inheritance of OSA as previously shown 13 . Furthermore, maternal asthma could also suggest abnormal airways, a trait the offspring could inherit and be associated with adult OSA.…”

Section: Discussionmentioning

confidence: 86%

Associations of early life and childhood risk factors with obstructive sleep apnoea in middle‐age

Senaratna,

Lowe,

Walters

et al. 2023

Respirology

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Background and ObjectiveEarly‐life risk factors for obstructive sleep apnoea (OSA) are poorly described, yet this knowledge may be critical to inform preventive strategies. We conducted the first study to investigate the association between early‐life risk factors and OSA in middle‐aged adults.MethodsData were from population‐based Tasmanian Longitudinal Health Study cohort (n = 3550) followed from 1st to 6th decades of life. Potentially relevant childhood exposures were available from a parent‐completed survey at age 7‐years, along with previously characterized risk factor profiles. Information on the primary outcome, probable OSA (based on a STOP‐Bang questionnaire cut‐off ≥5), were collected when participants were 53 years old. Associations were examined using logistic regression adjusting for potential confounders. Analyses were repeated using the Berlin questionnaire.ResultsMaternal asthma (OR = 1.5; 95% CI 1.1–2.0), maternal smoking (OR = 1.2; 1.05, 1.5), childhood pleurisy/pneumonia (OR = 1.3; 1.04, 1.7) and frequent bronchitis (OR = 1.2; 1.01, 1.5) were associated with probable OSA. The risk‐factor profiles of ‘parental smoking’ and ‘frequent asthma and bronchitis’ were also associated with probable OSA (OR = 1.3; 1.01, 1.6 and OR = 1.3; 1.01–1.9, respectively). Similar associations were found for Berlin questionnaire‐defined OSA.ConclusionsWe found novel temporal associations of maternal asthma, parental smoking and frequent lower respiratory tract infections before the age of 7 years with adult OSA. While determination of their pathophysiological and any causal pathways require further research, these may be useful to flag the risk of OSA within clinical practice and create awareness and vigilance among at‐risk groups.

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“…Given that CPAP is a significantly challenging treatment to use and has potential for long‐term changes to facial growth in children, future research efforts may be better directed to the use of CPAP for children with OSA and comorbid asthma. Studies in adults suggest a bidirectional association between OSA and asthma, with control of one condition affecting control of the other, although the underlying mechanisms remain unclear . Whether CPAP treatment for comorbid OSA and asthma improves asthma control is uncertain; however, CPAP can lead to important improvements in the associated symptoms of sleepiness, vitality and asthma‐related quality of life .…”

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confidence: 99%

“…Studies in adults suggest a bidirectional association between OSA and asthma, with control of one condition affecting control of the other, although the underlying mechanisms remain unclear . Whether CPAP treatment for comorbid OSA and asthma improves asthma control is uncertain; however, CPAP can lead to important improvements in the associated symptoms of sleepiness, vitality and asthma‐related quality of life . Given a higher rate of persistent OSA after adenotonsillectomy in children with asthma, CPAP may be an important adjunctive therapy in this setting.…”

mentioning

confidence: 99%