Medical Service, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
Chest. 2010 Sep;138(3):543-50. doi: 10.1378/chest.09-3066. Epub 2010 May 21.
Unrecognized obstructive sleep apnea (OSA) may lead to poor asthma control despite optimal therapy. Our objective was to evaluate the relationship between OSA risk and asthma control in adults.
Patients with asthma seen routinely at tertiary-care clinic visits completed the validated Sleep Apnea Scale of the Sleep Disorders Questionnaire (SA-SDQ) and Asthma Control Questionnaire (ACQ). An ACQ score of >or= 1.5 defined not-well-controlled asthma, and an SA-SDQ score of >or= 36 for men and >or= 32 for women defined high OSA risk. Logistic regression was used to model associations of high OSA risk with not-well-controlled asthma (ACQ full version and short versions).
Among 472 subjects with asthma, the mean +/- SD ACQ (full version) score was 0.87 +/- 0.90, and 80 (17%) subjects were not well controlled. Mean SA-SDQ score was 27 +/- 7, and 109 (23%) subjects met the definition of high OSA risk. High OSA risk was associated, on average, with 2.87-times higher odds for not-well-controlled asthma (ACQ full version) (95% CI, 1.54-5.32; P = .0009) after adjusting for obesity and other factors known to worsen asthma control. Similar independent associations were seen when using the short ACQ versions.
High OSA risk is significantly associated with not-well-controlled asthma independent of known asthma aggravators and regardless of the ACQ version used. Patients who have difficulty achieving adequate asthma control should be screened for OSA.
尽管接受了最佳治疗，但未被识别的阻塞性睡眠呼吸暂停（OSA）可能导致哮喘控制不佳。我们的目的是评估 OSA 风险与成年人哮喘控制之间的关系。
在三级保健诊所就诊的哮喘患者完成了经过验证的睡眠障碍问卷的睡眠呼吸暂停量表（SA-SDQ）和哮喘控制问卷（ACQ）。ACQ 评分>或= 1.5 定义为控制不佳的哮喘，男性 SA-SDQ 评分>或= 36，女性 SA-SDQ 评分>或= 32 定义为 OSA 高风险。使用逻辑回归对高 OSA 风险与控制不佳的哮喘（ACQ 完整版本和短版本）之间的关联进行建模。
在 472 例哮喘患者中，平均 ACQ（完整版本）评分±SD 为 0.87 ± 0.90，80 例（17%）患者控制不佳。SA-SDQ 平均得分为 27 ± 7，109 例（23%）患者符合 OSA 高风险的定义。在调整肥胖和其他已知会加重哮喘控制的因素后，高 OSA 风险与控制不佳的哮喘（ACQ 完整版本）的几率平均高出 2.87 倍（95%CI，1.54-5.32；P =.0009）。使用短 ACQ 版本时，也观察到类似的独立关联。
高 OSA 风险与控制不佳的哮喘显著相关，独立于已知的哮喘加重因素，且与使用的 ACQ 版本无关。那些难以实现充分哮喘控制的患者应进行 OSA 筛查。
