Cisneros Carolina, Iturricastillo Gorane, Martínez-Besteiro Elisa, Eiros José María, Marcos Celeste, Múgica Victoria, Melero Carlos, Martínez-Meca Ana, Landete Pedro, Zamora Enrique
Servicio de Neumología, Unidad de Asma de Alta Complejidad, Hospital Universitario de La Princesa, Madrid, Spain; Instituto de Investigación La Princesa, Unidad de Asma de Alta Complejidad, Madrid, Spain.
Servicio de Neumología, Unidad de Asma de Alta Complejidad, Hospital Universitario de La Princesa, Madrid, Spain.
Sleep Med. 2023 Jan;101:135-137. doi: 10.1016/j.sleep.2022.10.015. Epub 2022 Nov 2.
Obstructive sleep apnea (OSA) is an important risk factor for poor asthma control. The objective of this study is to analyze the symptomatic control in asthmatic patients with OSA after using continuous positive airway pressure (CPAP).
Patients were collected in a monographic asthma consult and a polygraphy was performed due to clinical suspicion or poor disease control. Asthma associated pathologies, as well as clinical and patient-perceived asthma control parameters were evaluated before and after the initiation of CPAP.
A hundred patients were included, 59% were women and 41% men. From them, 54% had severe OSA, 33% moderate OSA and 13% mild OSA, and 10% could not tolerate CPAP. Eighty four percent had a moderate or severe degree of asthma with fractional exhaled nitric oxide (FENO) 32 ± 24.6 ppm and an asthma control test (ACT) before CPAP of 19 ± 4. Asthma control before CPAP was good in 41% of patients, partial in 29%, and bad in 30%. After three or more months of CPAP, clinical asthma control was good in 70% (p < 0.001), perceived control by ACT after CPAP was 21 ± 4 (p < 0.001). When asked for their opinion, 51.5% referred clinical improvement after CPAP, no change in 46.5%.
The use of CPAP in asthmatic patients with OSA improves both clinical and perceived asthma control in a statistically significant way. Most patients had good adaptation to CPAP (90%) and 51.5% had clinical improvement.
阻塞性睡眠呼吸暂停（OSA）是哮喘控制不佳的一个重要风险因素。本研究的目的是分析持续气道正压通气（CPAP）治疗后，OSA哮喘患者的症状控制情况。
在一次专题哮喘会诊中收集患者，并因临床怀疑或疾病控制不佳进行多导睡眠监测。在开始CPAP治疗前后，评估哮喘相关病变以及临床和患者自我感知的哮喘控制参数。
共纳入100例患者，其中59%为女性，41%为男性。其中，54%患有重度OSA，33%患有中度OSA，13%患有轻度OSA，10%无法耐受CPAP。84%的患者哮喘程度为中度或重度，呼出一氧化氮分数（FENO）为32±24.6 ppm，CPAP治疗前哮喘控制测试（ACT）评分为19±4。CPAP治疗前，41%的患者哮喘控制良好，29%部分控制良好，30%控制不佳。CPAP治疗三个月或更长时间后，70%的患者临床哮喘控制良好（p<0.001），CPAP治疗后ACT自我感知控制评分为21±4（p<0.001）。当被问及意见时，51.5%的患者表示CPAP治疗后临床症状改善，46.5%的患者表示无变化。
在患有OSA的哮喘患者中使用CPAP可在统计学上显著改善临床和自我感知的哮喘控制。大多数患者对CPAP有良好的适应性（90%）且51.5%的患者有临床改善。
