Nocturnal Worsening of Asthma and Sleep-Disordered Breathing

Bohadana, Abraham; Hannhart, B.; Teculescu, D

doi:10.1081/jas-120002190

Cited by 67 publications

(31 citation statements)

References 90 publications

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“…Abnormalities of the nasopharynx and lower airways may co-exist due to similar airway responses to inflammatory or atopic stimuli [20]. Sleep deprivation, chronic upper airway edema, and inflammation associated with OSA may further exacerbate nocturnal asthma symptoms [22,23]. The "one airway" hypothesis suggests that upper airway inflammation and intermittent hypoxia from obstruction may influence the expression and severity of disease of the lower respiratory tract [24].…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea and history of asthma in snoring children

et al. 2008

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Asthma has been identified as a possible risk factor for Obstructive Sleep Apnea (OSA) in children. It is not known whether parent-reported asthma increases the likelihood of the diagnosis of OSA in snoring children. We hypothesized that snoring children with asthma are more likely to have OSA than snoring children without asthma. This study is a 1-year retrospective review of polysomnogram and questionnaire data collected on 236 patients referred to the University of Maryland Pediatric Sleep laboratory for evaluation of snoring. Of the 236 patients, 58% (137/236) were boys, and 79% (173/219 reporting race) were African-American (AA). The age at referral was 7.2±3.7 years (mean±S.D.). Mean body mass index (BMI) percentile was 73.4±32.3%, with 43.2% (54/125) >95th percentile. A history of asthma was reported by 31.4% (74/ 236); no subject was symptomatic on the night of the study. We found no increased risk for polysomnographically diagnosed OSA for asthmatics. To the contrary, by logistic regression analysis, a parent/guardian report of asthma decreased the odds of having OSA by 34% (p=0.027), controlling for individual and socioeconomic factors and assessment results. Polysomnographic (PSG) differences between asthmatic and non-asthmatic children were found in only the arousal index (11.0 vs.9.3±6.5/h, p=0.099) and total sleep time (337.1± 64.3 vs. 347±65.2 min, p=0.1) In a referral-based group of predominantly AA inner-city snoring children, asymptomatic asthma decreased the likelihood of OSA.

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Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea and history of asthma in snoring children

et al. 2008

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“…The recurrent upper airway obstruction might cause reflex bronchoconstriction by stimulating neural receptors in the pharyngeal region or by generating negative intrathoracic pressure. 9,20 Another plausible explanation relates to gastrooesophageal reflux (GOR); it is known that the large intrapleural pressure swings during apnoeic episodes facilitates GOR, 21 and GOR is a potential trigger of asthma that may occur even without oesophageal symptoms. 22 Recently, studies have shown that OSA is associated with systemic inflammation.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of asthma in patients with obstructive sleep apnoea

Alharbi

Almutairi

Alotaibi

et al. 2009

Primary Care Respiratory Journal

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“…Asthma might be more severe and difficult to control if OSA is present. Nasal continuous positive airway pressure (nCPAP) therapy can improve both the OSA and asthma [14,15]. The inflammatory mediators generated by OSA could possibly account for the cardiovascular and asthmatic complications [16•].…”

Section: Introductionmentioning

confidence: 99%

Rhinitis and sleep apnea

Staevska

Mandajieva

Dimitrov

2004

Curr Allergy Asthma Rep

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The nose and pharynx begin the upper airway system and represent a continuum. This is the biologic basis for the mutual influences of rhinitis and obstructive sleep apnea (OSA). Sleep-disordered breathing has a large differential diagnosis that includes snoring, upper airway resistance syndrome, and severe OSA. Nasal obstruction is an independent risk factor for OSA, but there is no correlation of daytime nasal resistance with the severity of OSA. However, nasal resistance was an independent predictor of apnea-hypopnea index in a recent study of nonobese OSA patients. Rhinitis alone is associated with mild OSA, but commonly causes microarousals and sleep fragmentation. Reduction of nasal inflammation with topical treatment improves sleep quality and subsequent daytime sleepiness and fatigue. Patient compliance with the nasal continuous positive airway pressure (nCPAP) device is relatively low, in part due to adverse nasal effects.

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Nocturnal Worsening of Asthma and Sleep-Disordered Breathing

Cited by 67 publications

References 90 publications

Obstructive sleep apnea and history of asthma in snoring children

Obstructive sleep apnea and history of asthma in snoring children

The prevalence of asthma in patients with obstructive sleep apnoea

Rhinitis and sleep apnea

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