North West Lung Centre, Wythenshawe Hospital, Manchester University Foundation Trust, Manchester, United Kingdom; Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom.
Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Department of Pulmonology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania.
Sleep Med Rev. 2022 Feb;61:101564. doi: 10.1016/j.smrv.2021.101564. Epub 2021 Nov 1.
Obstructive sleep apnoea (OSA) and asthma are two common respiratory disorders in children and adults. Apart from common risk factors, such as obesity, gastroesophageal reflux disease and allergic rhinitis, emerging evidence suggest that the two diseases may complicate the clinical course of each other. On one hand, OSA modifies asthmatic airway inflammation and is associated with poor asthma control. On the other hand, asthma and its medications increase the collapsibility of the upper airways contributing to the development and worsening of OSA. The overnight respiratory symptoms of OSA and asthma are often similar, and an inpatient polysomnography is often necessary for a proper diagnosis, especially in children. Continuous positive pressure, the gold standard treatment for OSA can improve asthma control in patients suffering from both diseases. However, there is limited evidence how anti-asthma medications act in the same patients. Nevertheless, adenotonsillectomy seems to be effective in children with concomitant asthma and OSA. This review summarises the evidence for the bidirectional link between asthma and OSA, focuses on diagnostic and therapeutic challenges and highlights the need for further research.
阻塞性睡眠呼吸暂停（OSA）和哮喘是儿童和成人常见的两种呼吸系统疾病。除肥胖、胃食管反流病和过敏性鼻炎等常见危险因素外，新出现的证据表明，这两种疾病可能会使彼此的临床病程复杂化。一方面，OSA 改变哮喘气道炎症，与哮喘控制不佳有关。另一方面，哮喘及其药物会增加上呼吸道的塌陷性，导致 OSA 的发生和恶化。OSA 和哮喘的夜间呼吸症状通常相似，因此通常需要进行住院多导睡眠图检查以做出正确诊断，尤其是在儿童中。持续气道正压通气是 OSA 的金标准治疗方法，可改善患有这两种疾病患者的哮喘控制。但是，关于抗哮喘药物在相同患者中的作用的证据有限。然而，腺样体扁桃体切除术似乎对同时患有哮喘和 OSA 的儿童有效。本综述总结了哮喘和 OSA 之间双向关联的证据，重点讨论了诊断和治疗方面的挑战，并强调了进一步研究的必要性。
