Sleep disturbances in patients with asthma

Janson, Christer; Gíslason, Þórarinn; Boman, Gunnar; Hetta, Jerker; Roos, B. E.

doi:10.1016/s0954-6111(08)80092-3

Cited by 94 publications

(65 citation statements)

References 16 publications

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“…We aimed to test the effects of inhaled FP on UAW collapsibility during sleep, and to assess tongue function changes and fat redistribution around UAW as potential underlying mechanisms. We hypothesized that inhaled FP would: (1) increase UAW collapsibility during sleep; (2) be associated with reduced wakefulness tongue strength and endurance and increased fat content around UAW structures. Preliminary results of this study were published in abstract form.…”

mentioning

confidence: 99%

Effects of Inhaled Fluticasone on Upper Airway during Sleep and Wakefulness in Asthma: A Pilot Study

Teodorescu

Xie

Sorkness

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objective: Obstructive sleep apnea is prevalent among people with asthma, but underlying mechanisms remain unknown. Inhaled corticosteroids may contribute. We tested the effects of orally inhaled fl uticasone propionate (FP) on upper airway (UAW) during sleep and wakefulness. Study design: 16-week single-arm study. Participants: 18 (14 females, mean [ ± SD] age 26 ± 6 years) corticosteroid-naïve subjects with mild asthma (FEV 1 89 ± 8% predicted). Interventions: High dose (1,760 mcg/day) inhaled FP. Measurements: (1) UAW collapsibility (passive critical closing pressure [Pcrit]); (2) tongue strength (maximum isometric pressure-Pmax, in KPa) and endurance-time (in seconds) able to maintain 50% Pmax across 3 trials (Ttot)-at anterior and posterior locations; (3) fat fraction and volume around UAW, measured by magnetic resonance imaging in three subjects. Results: Pcrit overall improved (became more negative) (mean ± SE) (-8.2 ± 1.1 vs. -12.2 ± 2.2 cm H 2 O, p = 0.04); the response was dependent upon baseline characteristics, with older, male gender, and worse asthma control predicting Pcrit deterioration (less negative). Overall, Pmax increased (anterior p = 0.02; posterior p = 0.002), but Ttot generally subsided (anterior p = 0.0007; posterior p = 0.06), unrelated to Pcrit response. In subjects studied with MRI, fat fraction and volume increased by 20.6% and 15.4%, respectively, without Pcrit changes, while asthma control appeared improved. Conclusions: In this study of young, predominantly female, otherwise healthy subjects with well-controlled asthma and stiff upper airways, 16-week high dose FP treatment elicited Pcrit changes which may be dependent upon baseline characteristics, and determined by synchronous and reciprocally counteracting local and lower airway effects. The long-term implications of these changes on sleep disordered breathing severity remain to be determined. S C I E N T I F I C I N V E S T I G A T I O N SG rowing evidence suggests that asthma patients have an increased predisposition for obstructive sleep apnea (OSA). Studies consistently fi nd higher prevalence of OSA symptoms among asthma patients.1-5 In a 14-year longitudinal study, asthma emerged as an independent risk factor for incident habitual snoring when adjusting for relevant confounders, including body mass index (BMI) at baseline and its change in time.6 Likewise, the prevalence of OSA diagnosed on polysomnography (PSG) is high (88% to 95.5%) in diffi cult-to-control asthma, 7,8 and follows asthma severity with 58% in moderate asthma versus 12% in controls. 7The mechanisms underlying this increased risk for OSA in asthma remain unknown. Apart from traditional OSA risk factors, BRIEF SUMMARYCurrent Knowledge/Study Rationale: Obstructive sleep apnea is more prevalent among people with asthma of increasing severity, but underlying mechanisms remain unknown. Inhaled corticosteroids may play a role. Study Impact: Sixteen-week treatment with inhaled fl uticasone elicited individual responses in upper airway collapsibility depe...

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mentioning

confidence: 99%

Effects of Inhaled Fluticasone on Upper Airway during Sleep and Wakefulness in Asthma: A Pilot Study

Teodorescu

Xie

Sorkness

et al. 2014

Journal of Clinical Sleep Medicine

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“…Regarding insomnia related to respiratory diseases, there are many reports on bronchial asthma [7,18] . COPD patients present various symptoms depending on the disease types and severity.…”

Section: Discussionmentioning

confidence: 99%

“…Insomnia, early morning awakening and daytime drowsiness are also observed in asthmatic patients not necessarily with respiratory failure [7]. We sometimes have no choice but to prescribe hypnotics for respiratory failure patients who complain of insomnia.…”

Section: Introductionmentioning

confidence: 99%

“…We sometimes have no choice but to prescribe hypnotics for respiratory failure patients who complain of insomnia. Although some studies [7] report that recent hypnotics are relatively safe for use in respiratory failure patients, most hypnotics and sedatives have some muscle relaxant and respiratory depression actions [8][9][10][11][12]. Therefore, hypnotics for sleep improvement should be administered carefully in CRF patients who complain of insomnia and tend to have daytime drowsiness.…”

Section: Introductionmentioning

confidence: 99%

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A study on sleep architecture in patients with chronic respiratory failure under long-term oxygen therapy—Focused on the influence of ventilatory failure (high CO<sub>2</sub>) elements on the patient’s sleep architecture

Nishijima¹,

Hosokawa²,

Mito³

et al. 2013

Health

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Sleep disturbance related symptoms are common in patients with long-term oxygen therapy (LTOT). Essentially, there were only few previous reports about the sleep architecture in patients with respiratory disease, such as chronic obstructive pulmonary disease (COPD). This study aims to clarify the objective sleep state and the elements that affect sleep architecture in Chronic Respiratory Failure (CRF) patients with focus on clinical cases of chronic hypercapnia. 13 subjects with chronic respiratory failure were enrolled in the study. All the subjects were preevaluated by pulmonary function test and Arterial blood gas analysis (ABG) including exercise testing. Polysomnography (PSG) test was performed in each subject with supplemental oxygen. The estimated base line PaCO 2 value that reflects overall PaCO 2 including sleep period was calculated using equation of from obtained ABG value just before PSG test. 6 subjects were classified as hypercapnic group (base line PaCO 2 ≥ 45 mmHg) and 7 subjects were non-hypercapnic group (base line PaCO 2 < 45 mmHg). Latency persistent sleep of PSG data was significant higher in patients with hypercapnic than non-hypercapnic (p < 0.01). Periodic Limb Movement was seen in 23.6% of the subjects, however there was no contribution for arousals. Other PSG data include mean SpO 2 were no significant difference. This study suggests that patients with estimated hypercapnia had more disturbed sleep architecture especially significant loss of sleep latency than non-hypercapnic patient with chronic respiratory failure under LTOT. Nocturnal PaCO 2 level or ventilatory function may contribute to sleep disturbance in patients with estimated hypercapnia during LTOT. ( )[ . ]

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“…Among the participants of the current study, adults with current asthma or previous asthma were more likely to sleep less than 7 hours every 24 hours at the time of survey compared to those without asthma (37%, 32% and 28%, respectively, p value of Pearson chi-square test < 0.001). Previous research has suggested that asthma patients are more likely to experience sleepiness during daytime hours [7,23,24] and that asthma condition and medications for asthma may impair sleep quality [8,25]. Moreover, there is substantial evidence suggesting that daytime sleepiness, inadequate sleep or poor sleep quality is an independent risk factor for injuries in both adults and children [11,12,[26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Asthma and Injury Risk: A Large Scale Population-Based Study

Liang¹,

Chikritzhs²

2012

IJCM

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Purpose: Clinical data suggest that asthma impairs sleep quality and further impairs cognitive performance during the daytime, while there is a causal relationship between impaired sleep quality and injuries. Therefore asthma patients may have increased risk of injury, and this is supported by our recent population-based studies conducted in Australia. This study is to investigate the effect of asthma on the risk of injury at the population level using data from the US National Health Interview Survey collected in 2008, 2009, and 2010. Method: Data from the 2008, 2009 and 2010 National Health Interview Surveys were combined and analyzed together. Results: US adults with current or previous asthma had significantly greater risk of injury compared to those without asthma. The risk of injury was also significantly higher among children with current asthma. Conclusion: This population-based study provided further evidence on the positive association between asthma and risk of injury among both adults and children. The increased risk of injury among asthma patients is at least partly due to impaired sleep quality and quantity caused by asthma symptoms and asthma medications.

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Sleep disturbances in patients with asthma

Cited by 94 publications

References 16 publications

Effects of Inhaled Fluticasone on Upper Airway during Sleep and Wakefulness in Asthma: A Pilot Study

Effects of Inhaled Fluticasone on Upper Airway during Sleep and Wakefulness in Asthma: A Pilot Study

A study on sleep architecture in patients with chronic respiratory failure under long-term oxygen therapy—Focused on the influence of ventilatory failure (high CO<sub>2</sub>) elements on the patient’s sleep architecture

Asthma and Injury Risk: A Large Scale Population-Based Study

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Sleep disturbances in patients with asthma

Cited by 94 publications

References 16 publications

Effects of Inhaled Fluticasone on Upper Airway during Sleep and Wakefulness in Asthma: A Pilot Study

Effects of Inhaled Fluticasone on Upper Airway during Sleep and Wakefulness in Asthma: A Pilot Study

A study on sleep architecture in patients with chronic respiratory failure under long-term oxygen therapy—Focused on the influence of ventilatory failure (high CO&lt;sub&gt;2&lt;/sub&gt;) elements on the patient’s sleep architecture

Asthma and Injury Risk: A Large Scale Population-Based Study

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Product

Resources

About

A study on sleep architecture in patients with chronic respiratory failure under long-term oxygen therapy—Focused on the influence of ventilatory failure (high CO<sub>2</sub>) elements on the patient’s sleep architecture