Abstract
This study evaluates the relationship between obstructive sleep apnea (OSA) and asthma. Literature search was carried out in several electronic databases and random effects meta-analyses were performed to obtain pooled estimates of the prevalence of OSA, OSA risk and sleep disordered breathing (SDB) in asthma patients and pooled odds ratios of the prevalence between asthma and non-asthma patients. In adult asthma patients, the prevalence [95% confidence interval] of OSA, OSA risk, and SDB was 49.50 [36.39, 62.60] %, 27.50 [19.31, 35.69] %, and 19.65 [14.84, 24.46] % respectively. The odds of having OSA, OS risk and SDB by the asthma patients were 2.64 [1.76, 3.52], 3.73 [2.90, 4.57] and 1.73 [1.11, 2.36] times higher (p < 0.00001 for all) in asthma than in non-asthma patients, respectively. Adult asthma patients with OSA had significantly higher BMI in comparison with asthma patients without OSA. This study reveals that the prevalence of OSA in asthma patients is considerably higher; even higher than OSA risk and SDB. Sleep studies should be performed in asthma patients with symptoms suggestive of OSA/OSA risk/SDB.
Highlights
Asthma is a common respiratory disorder with complex interactions between airflow obstruction, hyper-responsiveness, reversible expiratory flow limitation and inflammation[11], whereas obstructive sleep apnea (OSA) is characterized by snoring and interruptions in breathing during sleep with symptoms such as brief paroxysmal nocturnal dyspnea, choking during sleep, and nocturia along with daytime sleep, depression and memory loss[12, 13]
Because this area is not systematically reviewed, no summary estimates of the association between asthma and OSA are available for clinical and/or public health implications. Keeping in view this scenario, the present study was designed to carry out a systematic review of the relevant studies and to perform a meta-analysis of the indices that could display the relationship between asthma and OSA, OSA risk and sleep disordered breathing (SDB)
Obstructive sleep apnea is identified as an independent risk factor for asthma exacerbation[40], and OSA is reported to be more prevalent among patients with severe asthma than in moderate asthma which may be linked to the potential pathophysiologic interaction between OSA and asthma severity[30]
Summary
Asthma is a common respiratory disorder with complex interactions between airflow obstruction, hyper-responsiveness, reversible expiratory flow limitation and inflammation[11], whereas OSA is characterized by snoring and interruptions in breathing during sleep with symptoms such as brief paroxysmal nocturnal dyspnea, choking during sleep, and nocturia along with daytime sleep, depression and memory loss[12, 13]. Despite the recognition of high prevalence of OSA in asthma patients, highly variable prevalence estimates are reported in the individual studies. Because this area is not systematically reviewed, no summary estimates of the association between asthma and OSA are available for clinical and/or public health implications. Keeping in view this scenario, the present study was designed to carry out a systematic review of the relevant studies and to perform a meta-analysis of the indices that could display the relationship between asthma and OSA, OSA risk and sleep disordered breathing (SDB)
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