Obstructive sleep apneaPrevalence of obstructive sleep apnea–hypopnea in severe versus moderate asthma
Section snippets
Subjects
Subjects with asthma were recruited from our Difficult Asthma Program.2 Recruitment to the program was solely on the basis of asthma history. Severe asthma was defined according to American Thoracic Society criteria1 and required at least 1 major criterion: daily oral steroids for >50% of the previous 12 months, or high-dose inhaled steroid: fluticasone ≥1000 μg/d or equivalent, and at least 1 other add-on therapy continuously for ≥12 months; and ≥2 minor criteria: daily short-acting β-agonist,
Results
Subject characteristics are shown in Table I. The 3 groups were of similar age, sex distribution, and BMI. Flow rates were significantly lower and Juniper asthma control questionnaire scores significantly higher (poorer control) among the severe versus moderate asthma groups, as anticipated. Asthma quality of life scores were significantly lower (less favorable) for patients with severe asthma than for patients with moderate asthma. Eight patients with severe asthma (31%) and 2 patients with
Discussion
In this study, by using complete overnight polysomnography, we identified a strikingly high prevalence of OSAH among patients with severe asthma compared with age-matched and BMI-matched patients with moderate asthma and control subjects without asthma. OSAH also tended to be more prevalent among patients with moderate asthma than controls without asthma, although this did not achieve statistical significance. Mean nocturnal SaO2 was significantly lower for the severe asthma group compared with
References (37)
- et al.
Differences in airway remodeling between subjects with severe and moderate asthma
J Allergy Clin Immunol
(2005) - et al.
Effect of nasal continuous positive airway pressure in uncontrolled nocturnal asthmatic patients with obstructive sleep apnea syndrome
Respir Med
(2005) - et al.
Symptoms related to obstructive sleep apnoea are common in subjects with asthma, chronic bronchitis and rhinitis in a general population
Respir Med
(2001) - et al.
Correlates of daytime sleepiness in patients with asthma
Sleep Med
(2006) - et al.
Irregular breathing and hypoxaemia during sleep in chronic stable asthma
Lancet
(1982) - et al.
Laryngeal inflammation assessed using the reflux finding score in obstructive sleep apnea
Otolaryngol Head Neck Surg
(2006) - et al.
Predictors of habitual snoring and obstructive sleep apnea risk in patients with asthma
Chest
(2009) - et al.
Obstructive sleep apnea syndrome and inflammation
J Allergy Clin Immunol
(2005) Obesity and asthma: possible mechanisms
J Allergy Clin Immunol
(2008)- et al.
Sleep apnea: a proinflammatory disorder that coaggregates with obesity
J Allergy Clin Immunol
(2008)
Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions. American Thoracic Society
Am J Respir Crit Care Med
Nocturnal asthma: role of snoring and obstructive sleep apnea
Am Rev Respir Dis
Risk factors of frequent exacerbations in difficult-to-treat asthma
Eur Respir J
Difficult-to-control asthma and obstructive sleep apnea
J Asthma
Impact of CPAP on asthmatic patients with obstructive sleep apnoea
Eur Respir J
Sleep quality in asthma: results of a large prospective clinical trial
J Asthma
Nocturnal asthma: snoring, small pharynx and nasal CPAP
Eur Respir J
Development and validation of a questionnaire to measure asthma control
Eur Respir J
Cited by (0)
Supported by grants from the Richard and Edith Strauss Canada Foundation, McGill University Health Centre Research Institute, and the Fonds de la Recherche en Santé du Québec. J.Y.J. was a recipient of the Ann Woolcock Memorial Fellowship, was supported by GlaxoSmithKline Canada Inc, and is a CHEST Foundation Awardee. R.J.K. was a Clinical Research Scholar of the Fonds de la Recherche en Santé du Québec. Q.H. is a recipient of a Chercheur Nationale award from the Fonds de la Recherche en Santé du Québec.
Disclosure of potential conflict of interest: P. Ernst is on the advisory board and speakers' bureau for AstraZeneca, GlaxoSmithKline, Merck, Novartis, Nycomed, and Pfizer and receives grant support from the Canadian Institutes of Health Research. R. Olivenstein receives grant support from Novartis and Asthmatx. Catherine Lemière receives grant support from the National Institute for Occupational Safety and Health and the Institut de Recherche Robert-Sauvé en Santé et en Securité du Travail. R. J. Kimoff receives speaker fees from GlaxoSmithKline and VitalAire Inc and receives grant support from the Fonds de la Recherche en Santé du Québec and the Multiple Sclerosis Society of Canada. The rest of the authors have declared that they have no conflict of interest.