OBJECTIVE: Obstructive sleep apnea (OSA) worsens nocturnal asthma, but its potential impact on daytime asthma remains largely unassessed. We investigated whether the sleep disorder is associated with daytime, in addition to nighttime, asthma symptoms. METHODS: Asthma patients at tertiary-care centers completed the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ), and an asthma control questionnaire. SA-SDQ scores ≥36 for males and ≥32 for females defined high OSA risk. Medical records were reviewed for established diagnosis of OSA and continuous positive airway pressure (CPAP) use. RESULTS: Among 752 asthma patients, high OSA risk was associated similarly with persistent daytime and nighttime asthma symptoms (p < .0001 for each). A diagnosis of OSA was robustly associated with persistent daytime (p < .0001) in addition to nighttime (p = .0008) asthma symptoms. In regression models that included obesity and other known asthma aggravators, high OSA risk retained associations with persistent daytime (odds ratio [OR] = 1.96 [95% confidence interval [CI] = 1.31-2.94]) and nighttime (1.97 [1.32-2.94]) asthma symptoms. Diagnosed OSA retained an association with persistent daytime (2.08 [1.13-3.82]) but not with nighttime (1.48 [0.82-2.69]) asthma symptoms. CPAP use was associated with lower likelihood of persistent daytime symptoms (0.46 [0.23-0.94]). CONCLUSIONS: Questionnaire-defined OSA risk and historical diagnosis were each associated with persistent daytime asthma symptoms, to an extent that matched or exceeded associations with nighttime asthma symptoms. Unrecognized OSA may be a reason for persistent asthma symptoms during the day as well as the night.
OBJECTIVE:Obstructive sleep apnea (OSA) worsens nocturnal asthma, but its potential impact on daytime asthma remains largely unassessed. We investigated whether the sleep disorder is associated with daytime, in addition to nighttime, asthma symptoms. METHODS:Asthmapatients at tertiary-care centers completed the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ), and an asthma control questionnaire. SA-SDQ scores ≥36 for males and ≥32 for females defined high OSA risk. Medical records were reviewed for established diagnosis of OSA and continuous positive airway pressure (CPAP) use. RESULTS: Among 752 asthmapatients, high OSA risk was associated similarly with persistent daytime and nighttime asthma symptoms (p < .0001 for each). A diagnosis of OSA was robustly associated with persistent daytime (p < .0001) in addition to nighttime (p = .0008) asthma symptoms. In regression models that included obesity and other known asthma aggravators, high OSA risk retained associations with persistent daytime (odds ratio [OR] = 1.96 [95% confidence interval [CI] = 1.31-2.94]) and nighttime (1.97 [1.32-2.94]) asthma symptoms. Diagnosed OSA retained an association with persistent daytime (2.08 [1.13-3.82]) but not with nighttime (1.48 [0.82-2.69]) asthma symptoms. CPAP use was associated with lower likelihood of persistent daytime symptoms (0.46 [0.23-0.94]). CONCLUSIONS: Questionnaire-defined OSA risk and historical diagnosis were each associated with persistent daytime asthma symptoms, to an extent that matched or exceeded associations with nighttime asthma symptoms. Unrecognized OSA may be a reason for persistent asthma symptoms during the day as well as the night.
Authors: Faith S Luyster; Mihaela Teodorescu; Eugene Bleecker; William Busse; William Calhoun; Mario Castro; Kian Fan Chung; Serpil Erzurum; Elliot Israel; Patrick J Strollo; Sally E Wenzel Journal: Sleep Breath Date: 2011-11-20 Impact factor: 2.816
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Authors: Michael C Hlavac; Peter G Catcheside; Rachel McDonald; Danny J Eckert; Samantha Windler; R Doug McEvoy Journal: Sleep Date: 2006-05 Impact factor: 5.849
Authors: A ten Brinke; P J Sterk; A A M Masclee; P Spinhoven; J T Schmidt; A H Zwinderman; K F Rabe; E H Bel Journal: Eur Respir J Date: 2005-11 Impact factor: 16.671
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Authors: Mihaela Teodorescu; Oleg Broytman; Douglas Curran-Everett; Ronald L Sorkness; Gina Crisafi; Eugene R Bleecker; Serpil Erzurum; Benjamin M Gaston; Sally E Wenzel; Nizar N Jarjour Journal: J Allergy Clin Immunol Pract Date: 2015-05-21
Authors: Mihaela Teodorescu; Jodi H Barnet; Erika W Hagen; Mari Palta; Terry B Young; Paul E Peppard Journal: JAMA Date: 2015-01-13 Impact factor: 56.272