患有或不患有合并性鼻炎的哮喘患者的睡眠呼吸暂停风险。

Sleep apnea risk in subjects with asthma with or without comorbid rhinitis.

作者信息

Braido Fulvio, Baiardini Ilaria, Lacedonia Donato, Facchini Fabrizio M, Fanfulla Francesco, Molinengo Giorgia, Canonica Giorgio W

机构信息

Allergy and Respiratory Diseases Clinic, Department of Internal Medicine and Medical Specialties, University of Genoa and the Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Instituto Scientifico Tumori, Genoa, Italy.

Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.

出版信息

Respir Care. 2014 Dec;59(12):1851-6. doi: 10.4187/respcare.03084. Epub 2014 Jun 10.

DOI:10.4187/respcare.03084

PMID:24917451

Abstract

BACKGROUND

As many as 80% of patients with asthma suffer from allergic rhinitis (AR), and rhinitis symptoms are associated with sleep complaints The aim of this cross-sectional study was to assess the prevalence of obstructive sleep apnea syndrome risk in patients with asthma and to explore the association between comorbid rhinitis and obstructive sleep apnea syndrome risk.

METHODS

Subjects with asthma were recruited by general practitioners during a control visit. Physicians compiled a questionnaire that assessed the presence of AR according to ARIA (Allergic Rhinitis and Its Impact on Asthma) guidelines and factors influencing the risk of obstructive sleep apnea syndrome (gastroesophageal reflux disease, obesity, smoking). Subjects completed a questionnaire evaluating the presence and severity of AR and the STOP-BANG questionnaire (snoring, tiredness during daytime, observed apnea, high blood pressure, body mass index, age, neck circumference, gender), a validated screening method to identify obstructive sleep apnea syndrome risk. Physicians were blinded to the subjects' questionnaires, ensuring objectivity of the method.

RESULTS

The analyses were conducted on 1,941 subjects (males 58%, mean age 48.2 ± 15.2 y): 740 with asthma alone and 1,201 with asthma and AR. STOP-BANG revealed that 52.6% of the subjects were at increased risk of obstructive sleep apnea syndrome: 47.3% of subjects with asthma alone and 55.9% of patients with asthma and AR. Rhinitis was associated with a 1.44 times higher odds ratio for having obstructive sleep apnea syndrome risk. Rhinitis duration and severity were associated with obstructive sleep apnea syndrome risk, although the latter deserved greater importance. The results showed that, once a correction for each of these factors was performed, subjects with AR with an odds ratio of 1.99 were reported to be at risk of obstructive sleep apnea syndrome.

CONCLUSIONS

The probable increased risk of obstructive sleep apnea syndrome is associated with the concomitant presence of rhinitis, independent of obesity and other contributors to risk of obstructive sleep apnea syndrome.

摘要

背景

多达80%的哮喘患者患有过敏性鼻炎（AR），且鼻炎症状与睡眠问题相关。这项横断面研究的目的是评估哮喘患者中阻塞性睡眠呼吸暂停综合征风险的患病率，并探讨合并鼻炎与阻塞性睡眠呼吸暂停综合征风险之间的关联。

方法

全科医生在一次对照访视期间招募哮喘患者。医生编制了一份问卷，根据ARIA（变应性鼻炎及其对哮喘的影响）指南评估AR的存在情况以及影响阻塞性睡眠呼吸暂停综合征风险的因素（胃食管反流病、肥胖、吸烟）。受试者完成一份评估AR的存在情况和严重程度的问卷以及STOP - BANG问卷（打鼾、白天疲倦、观察到的呼吸暂停、高血压、体重指数、年龄、颈围、性别），这是一种经过验证的用于识别阻塞性睡眠呼吸暂停综合征风险的筛查方法。医生对受试者的问卷不知情，以确保该方法的客观性。

结果

对1941名受试者（男性占58%，平均年龄48.2±15.2岁）进行了分析：740名单纯哮喘患者和1201名合并哮喘和AR的患者。STOP - BANG显示，52.6%的受试者阻塞性睡眠呼吸暂停综合征风险增加：单纯哮喘患者中47.3%，合并哮喘和AR的患者中55.9%。鼻炎与阻塞性睡眠呼吸暂停综合征风险的比值比高1.44倍相关。鼻炎病程和严重程度与阻塞性睡眠呼吸暂停综合征风险相关，尽管后者更为重要。结果表明，一旦对这些因素中的每一个进行校正，AR患者中比值比为1.99的患者被报告有阻塞性睡眠呼吸暂停综合征风险。