Asthma may contribute to obstructive sleep apnea
By Debbie Nicholson
Obstructive sleep apnea (OSA) is more common among asthmatics, but whether asthma promotes development of OSA remains unknown, according to the study's abstract.
Several studies have suggested that people with asthma could be at an increased risk for sleep apnea and that sleep apnea can worsen asthma.
Dr. Mihaela Teodorescu, MD, Assistant Professor of Medicine at the University of Wisconsin in Madison, related to MedPage Today "There has been a body of evidence published suggesting that there is a relationship between obstructive sleep apnea and asthma.” "Each disorder makes the other worse, so understanding what starts this vicious cycle is very important. We asked the question of whether asthma promotes the development of obstructive sleep apnea."
Dr. Teodorescu and colleagues set out to determine if the presence or development of asthma affects the risk of new-onset OSA in Wisconsin Sleep Cohort Study (WSCS) participants.
During the study at four year intervals, WSCS participants aged 30 to 60 years in 1988 completed in-laboratory polysomnography, clinical assessments and health history questionnaires.
Asthma was self-identified by participants in the study at the start of research had a 41% incident obstructive sleep apnea rate, compared with an obstructive sleep apnea incident rate of 29% among participants who did not report asthma at the beginning of the study according to Dr. Teodorescu.
Among the 205 participants who reported a history of asthma, 84 participants developed OSA during the eight year intervals sleep studies. Among the 1,278 participants who entered the study without self-reports of asthma, 369 participants developed OSA after eight years.
In their conclusion the researchers write “In adults, presence of asthma, particularly childhood onset asthma, predicted 8-year risk of developing OSA. Incremental asthma duration by five years raised the odds for OSA 8-year later by 10%.
Dr. Teodorescu explains "In this cohort we found that having asthma at baseline predicted an increased incidence of obstructive sleep apnea 8 years later.” "Overall, having any asthma at baseline predicted about a 72% higher likelihood of developing obstructive sleep apnea 8 years later.”
"Interestingly, when stratifying by the age of diagnosis, childhood onset of asthma was a higher predictor for development of obstructive sleep apnea, with an odds ratio of about 2.1," she said in a press briefing following her poster presentation.
"For each 5 years increment in duration of asthma, the likelihood of developing obstructive sleep apnea increased by 12%," she said.
Dr. Susheel Patil, MD, PhD, Instructor of Medicine, John Hopkins University, Moderator for press briefing, stated "Over the years obstructive sleep apnea has been found not to just be associated with excessive daytime sleepiness but has been associated with other diseases such as cardiovascular outcomes, diabetes and metabolic syndromes."
"I think that the relationship between asthma and obstructive sleep apnea may, indeed, be bidirectional as exhibited in this new study," he reported to MedPage Today.
Dr. Teodorescu stated "We selected people in the cohort who were free of obstructive sleep apnea at baseline.” "We stratified them based on their asthma diagnosis which was self-reported and they also self-reported the duration of asthma. We didn't see any differences in obstructive sleep apnea severity when we looked at stratification of asthmatics versus no asthma, but the sample sizes became quite small when we tried to separate these groups."
In closing Dr. Teodorescu stated "Overall we conclude that these prospective data suggest that asthma, particularly of childhood onset may contribute to the development of obstructive sleep apnea later on in life. Childhood asthma onset seems to be more of a risk factor for this disease.”"How intrinsic disease characteristics or associated features starting early in life affect upper airway patency during sleep remains unknown.'
The findings were reported at he annual meeting of the American Thoracic Society in Philadelphia.
Because of the link between sleep-disordered breathing and asthma, if one of the disorders is diagnosed, it would be beneficial to test for the other as well.
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