Link Between Obstructive Sleep Apnea and Asthma

Asthma is linked to new onset obstructive sleep apnea (OSA), according to research published in the Journal of the American Medical Association (JAMA).

Researchers lead by Mihaela Teodorescu, MD, MS, of the William S. Middleton Memorial Veteran’s Hospital, and the University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin assessed questionnaires completed by adult participants in order to examine the prospective relationship of asthma with incident OSA. The participants were recruited from random samples in the state of Wisconsin state employees to attend overnight polysomnography studies from 1988 through March 2013. The eligible participants did not have OSA, which was confirmed by 2 baseline polysomnography tests. A total of 547 participants, of whom 52 percent were women and were aged an average of 50 years, received 1105 follow ups over 4 years.

Out of 81 participants with asthma, 21 experienced incident OSA over their first observed 4 year follow up interval, compared to 75 of 466 participants without asthma (27 percent versus 16 percent, respectively). When analyzing all of the 4 year follow up intervals, participants with asthma experienced 45 cases of OSA during 167 4 year intervals (27 percent), while participants without asthma experienced 160 cases of incident OSA during the 938 4 year follow up intervals (17 percent).

The researchers also determined that asthma was linked to new onset OSA with habitual sleepiness. Additionally, asthma duration was related to both incident OSA and incident OSA with habitual sleepiness.

“This study prospectively examined the relationship of asthma with OSA assessed with laboratory based polysomnography and found that preexistent asthma was a risk factor for the development of clinically relevant OSA in adulthood over a 4 year period,” the authors concluded. “Furthermore, the asthma OSA association was significantly dose dependent on duration of asthma. Studies investigating the mechanisms underlying this association and the value of periodic OSA evaluation in patients with asthma are warranted.”

Prior research suggested an association between the conditions; however researchers weren’t sure until this study that there was a definite link.

“We didn’t know up to this point that asthma may lead to OSA, but what we did know was that once established, OSA tends to worsen asthma control, so we’re looking at this vicious cycle of relationships between OSA and asthma,” Teodorescu said in a statement. “Finding out that asthma promotes the development of OSA gives us some understanding that we really need to periodically screen patients with asthma for OSA because they may develop OSA, which in turn can worsen asthma control.”