Abstract
Bronchial asthma (BA) and obstructive sleep apnea (OSA) are common respiratory obstructive diseases that may coexist. It would be interesting to study the possible influence of that coexistence on both diseases. Until now, reviews focused mainly on epidemiology. The aim of this study was to review the literature in relation to epidemiology, pathophysiology, consequences, screening of patients, and treatment of the coexistence of OSA and BA. We pooled studies from the PubMed database from 1986 to 2019. OSA prevalence in asthmatics was found to be high, ranging from19% to 60% in non-severe BA, reaching up to 95% in severe asthma. Prevalence was correlated with the duration and severity of BA, and increased dosage of steroids taken orally or by inhalation. This high prevalence of the coexistence of OSA and BA diseases could not be a result of just chance. It seems that this coexistence is based on the pathophysiology of the diseases. In most studies, OSA seems to deteriorate asthma outcomes, and mainly exacerbates them. CPAP (continuous positive airway pressure) treatment is likely to improve symptoms, the control of the disease, and the quality of life in asthmatics with OSA. However, almost all studies are observational, involving a small number of patients with a short period of follow up. Although treatment guidelines cannot be released, we could recommend periodic screening of asthmatics for OSA for the optimal treatment of both the diseases.
Highlights
IntroductionBronchial asthma is a common inflammatory respiratory disease affecting up to 1–18% of the population in different countries
Bronchial asthma is a common inflammatory respiratory disease affecting up to 1–18% of the population in different countries. It is characterized by bronchial hyper-responsiveness (BHR) and presents with variable symptoms including wheezing, shortness of breath, chest tightness, and cough that vary according to disease severity [1]
High obstructive sleep apnea (OSA) risk associated with persistent daytime (OR = 1.96, 95% CI = 1.31–2.94) and night-time (OR = 1.97, 95% CI = 1.32–1.94) asthma symptoms
Summary
Bronchial asthma is a common inflammatory respiratory disease affecting up to 1–18% of the population in different countries. The gold standard for the diagnosis is the improvement of forced expiratory volume in the first second (FEV1) >12% and 200 mL, 10–20 min after the inhalation of 100–200 mg of salbutamol [1].Almost 5–10% of asthmatics have severe, refractory asthma despite optimal therapy, and experience frequent exacerbations, hospital admissions, and healthcare utilization. They often use high doses of inhaled or oral steroids. Asthma control is assessed using validated questionnaires such as the asthma control questionnaire (ACQ) and the asthma control test (ACT) [1]
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