Chamara V Senaratna1,2, E Haydn Walters3, Garun Hamilton4,5, Adrian J Lowe1, Caroline Lodge1, John Burgess1, Bircan Erbas6, Graham G Giles7,8,9, Paul Thomas10, Michael J Abramson7, Bruce Thompson11, Jennifer L Perret1, Shyamali C Dharmage1. 1. Allergy and Lung Health, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. 2. Department of Community Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka. 3. The University of Tasmania, Hobart, TAS, Australia. 4. School of Clinical Sciences, Monash University, Melbourne, VIC, Australia. 5. Department of Lung and Sleep, Monash Health, Melbourne, VIC, Australia. 6. School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia. 7. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 8. Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia. 9. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. 10. School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia. 11. Department of Medicine, Monash University, Melbourne, VIC, Australia.
Abstract
BACKGROUND AND OBJECTIVE: Obstructive sleep apnoea (OSA) and asthma are associated, and nocturnal breathing difficulty that is usually identified as asthma-like symptoms can be present in both conditions. We investigated how nocturnal asthma-like symptoms (NAS) and bronchial hyper-reactivity (BHR) contribute to the association between OSA risk and current asthma, which is currently unknown but a clinically important question. METHODS: We used data from 794 middle-aged participants in a population-based cohort who provided information on OSA risk (defined by a STOP-Bang questionnaire score of at least 3), current asthma and NAS, and underwent methacholine bronchial challenge testing. Using regression models, we examined the association between OSA risk and current asthma-NAS subgroups and investigated any effect modification by BHR. RESULTS: The participants were aged 50 years (49.8% male). OSA risk was associated with NAS with or without current asthma (odds ratio (OR): 2.6; 95% CI = 1.3-5.0; OR: 4.2; 95% CI = 1.1-16.1, respectively), but not with current asthma in the absence of NAS. BHR was associated with current asthma with or without NAS (OR: 2.9; 95% CI = 1.4-5.9; OR: 3.4; 95% CI = 2.0-7.0, respectively) but not with NAS in the absence of current asthma. The associations between OSA risk and current asthma were neither modified nor mediated by BHR. CONCLUSION: Our findings suggest that some of the nocturnal symptoms perceived as asthma may be OSA symptoms. Patients with nocturnal asthma symptoms should be considered for possible OSA.
BACKGROUND AND OBJECTIVE:Obstructive sleep apnoea (OSA) and asthma are associated, and nocturnal breathing difficulty that is usually identified as asthma-like symptoms can be present in both conditions. We investigated how nocturnal asthma-like symptoms (NAS) and bronchial hyper-reactivity (BHR) contribute to the association between OSA risk and current asthma, which is currently unknown but a clinically important question. METHODS: We used data from 794 middle-aged participants in a population-based cohort who provided information on OSA risk (defined by a STOP-Bang questionnaire score of at least 3), current asthma and NAS, and underwent methacholine bronchial challenge testing. Using regression models, we examined the association between OSA risk and current asthma-NAS subgroups and investigated any effect modification by BHR. RESULTS: The participants were aged 50 years (49.8% male). OSA risk was associated with NAS with or without current asthma (odds ratio (OR): 2.6; 95% CI = 1.3-5.0; OR: 4.2; 95% CI = 1.1-16.1, respectively), but not with current asthma in the absence of NAS. BHR was associated with current asthma with or without NAS (OR: 2.9; 95% CI = 1.4-5.9; OR: 3.4; 95% CI = 2.0-7.0, respectively) but not with NAS in the absence of current asthma. The associations between OSA risk and current asthma were neither modified nor mediated by BHR. CONCLUSION: Our findings suggest that some of the nocturnal symptoms perceived as asthma may be OSA symptoms. Patients with nocturnal asthma symptoms should be considered for possible OSA.
Authors: Xiaoshu Cao; Cristina de Oliveira Francisco; T Douglas Bradley; Nasim Montazeri Ghahjaverestan; Susan M Tarlo; Matthew B Stanbrook; Kenneth R Chapman; Mark Inman; Azadeh Yadollahi Journal: Nat Sci Sleep Date: 2022-05-06