Saxena Damini, Imayama Ikuyo, Adrish Muhammad
Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois, Chicago, IL 60607, USA.
J Clin Med. 2023 Oct 16;12(20):6552. doi: 10.3390/jcm12206552.
Asthma and obstructive sleep apnea are highly prevalent conditions with a high cost burden. In addition to shared risk factors, existing data suggest a bidirectional relationship between asthma and OSA, where each condition can impact the other. Patients with asthma often complain of sleep fragmentation, nocturnal asthma symptoms, daytime sleepiness, and snoring. The prevalence of OSA increases with asthma severity, as evidenced by multiple large studies. Asthma may lower the threshold for arousal in OSA, resulting in the hypopnea with arousal phenotype. Epidemiologic studies in adults have shown that OSA is associated with worse asthma severity, increased frequency of exacerbation, and poor quality of life. The current literature assessing the relationship among OSA, asthma, and CPAP therapy is heavily dependent on observational studies. There is a need for randomized controlled trials to minimize the interference of confounding shared risk factors.
哮喘和阻塞性睡眠呼吸暂停是高发性疾病，成本负担高昂。除了共同的风险因素外，现有数据表明哮喘与阻塞性睡眠呼吸暂停之间存在双向关系，即每种疾病都可能影响另一种疾病。哮喘患者经常抱怨睡眠碎片化、夜间哮喘症状、日间嗜睡和打鼾。多项大型研究表明，阻塞性睡眠呼吸暂停的患病率随哮喘严重程度的增加而升高。哮喘可能会降低阻塞性睡眠呼吸暂停患者的觉醒阈值，导致伴有觉醒表型的呼吸浅促。针对成年人的流行病学研究表明，阻塞性睡眠呼吸暂停与更严重的哮喘、更高的发作频率和较差的生活质量相关。目前评估阻塞性睡眠呼吸暂停、哮喘和持续气道正压通气治疗之间关系的文献严重依赖观察性研究。需要进行随机对照试验，以尽量减少混杂的共同风险因素的干扰。
