Garza Nicholas, Witmans Manisha, Salud Martina, Lagera Pamela Gail D, Co Vince Aaron, Tablizo Mary Anne
Valley Children's Hospital, Madera, CA 93636, USA.
Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2B7, Canada.
Children (Basel). 2022 Sep 21;9(10):1430. doi: 10.3390/children9101430.
Obstructive sleep apnea (OSA) and asthma are two of the most prevalent and commonly co-existing respiratory conditions seen in the pediatric population. Studies linking asthma and OSA in children are limited but indicate that there is a bi-directional relationship between them with significant overlap in the symptoms, risk factors, pathophysiology, comorbidities, and management. It is suggested that there is a reciprocal association between asthma predisposing to OSA, and OSA worsening symptom control and outcomes from asthma. It stands to reason that inflammation in the upper and/or lower airways can influence each other. Most of the pediatric literature that is available evaluates each aspect of this relationship independently such as risk factors, mechanisms, and treatment indications. This article highlights the relationship between OSA and asthma in the context of shared risk factors, pathophysiology, and available management recommendations in the pediatric population. Early recognition of the co-existence and association between OSA and asthma could ideally improve the treatment outcomes for these two conditions. Gaining a better understanding of the mechanism of this relationship can help identify nuances for medical management, optimize treatment and protect this population at risk from associated morbidity.
阻塞性睡眠呼吸暂停（OSA）和哮喘是儿科人群中最常见且常并存的两种呼吸道疾病。关于儿童哮喘与OSA之间关联的研究有限，但表明它们之间存在双向关系，在症状、危险因素、病理生理学、合并症及管理方面有显著重叠。有人认为，哮喘易引发OSA，而OSA会使哮喘症状控制及预后恶化，二者存在相互关联。上呼吸道和/或下呼吸道的炎症相互影响是合理的。现有大多数儿科文献分别独立评估这种关系的各个方面，如危险因素、机制和治疗指征。本文在儿科人群共同的危险因素、病理生理学及现有管理建议的背景下，重点阐述OSA与哮喘之间的关系。尽早认识到OSA与哮喘的并存及关联，理论上可改善这两种疾病的治疗效果。更好地理解这种关系的机制有助于确定医疗管理的细微差别，优化治疗，并保护这一高危人群免受相关发病风险的影响。
