Assessment of the prevalence of obstructive sleep apnea in patients with stable uncontrolled asthma, impact of continuous positive airway pressure treatment

There are increasing data about the association between bronchial asthma and obstructive sleep apnea (OSA) is an important contributor to asthma control and can aggravate asthma exacerbation, continuous positive airway pressure (CPAP) which is the main line of treatment in OSA can improve asthma outcomes.Aim of the present studyTo assess the prevalence of OSA in patients with stable uncontrolled asthma and to study the effect of CPAP treatment on the asthma condition.Subjects and methodsSixty subjects with uncontrolled bronchial asthma were included in the study, mean age was 46 ± 13 years, there were female predominance (75%), all patients were not smokers, pregnancy and patients in acute exacerbation were excluded, after detailed history taking and physical examination pulmonary function tests and asthma control test were applied to all patients to assess the asthma control, then polysomnography was done to all patients and those proved to have OSA were offered CPAP treatment and followed up for 6 weeks then assessed again for asthma control test, pulmonary function tests and day – time sleepiness.ResultsFifteen patients out of the 60 patients included in the study proved to have OSA, Apnea Hypopnea Index (AHI) was 23.5 ± 10.9/h of sleep, CPAP treatment improved significantly the AHI (from 23.5 ± 10.9 to 2.3 ± 2.1/h of sleep, p < 0.01), but there was no significant improvement in asthma control test or in the pulmonary functions (ACT was 13.97 ± 3.52 before CPAP and became 14.1 ± 3.97, p > 0.05 after CPAP, FEV1% pred. was 60.1 ± 6.9 before CPAP and became 61.2 ± 6.2, p > 0.05 after CPAP.ConclusionObstructive sleep apnea should be screened for in all patients with uncontrolled bronchial asthma, CPAP treatment may improve asthma quality of life but not improving the pulmonary function tests. Larger studies are needed to fully address the impact of CPAP on asthma condition in patient with both asthma and OSA.