Obstructive sleep apnea syndrome with asthma patient

AbstractObjective and Introduction: Obesity is a common risk factor for two prevalent disorders, namely asthma and obstructive sleep apnea syndrome (OSAS). Similarly, anatomical and functional abnormalities of the upper airways and reflux are other associated factors. It is known that symptoms associated with asthma are generally more severe at nights. Moreover, upper airways as the essential area in the pathophysiology of OSAS also constitute the mainly affected region in asthma. Therefore these two different disorders can cause each other as having a mutual pathway in etiology. The objective of this study was to investigate the prevalence of OSAS in patients with asthma and its effect on the severity and the management of asthma.Material and Methods: The consecutive 50 asthma patients (35 female and 15 male) attending the outpatient clinic of the department of Chest Diseases were included in this study. All of these patients were undergone to Polysomnographic examination.Results: The overall prevalence of OSAS was 40% in asthma patients. This ratio was 16% regarding the moderate and severe OSAS. However, the prevalence of OSAS according to the severity of asthma were not significantly related. Although the prevalence of OSAS was increased in well controlled asthmatic patients, this relation was not statistically significant. Snoring was observed in all asthma cases with OSAS. Particularly, the prevalence of OSAS was significantly more common in asthma patients having the symptoms of habitual snoring, witnessed apnea, daytime sleepiness than those of not. The incidence of major symptoms was positively correlated with the incidence of OSAS. Similarly, as the diameter of the neck and body mass index in asthma patients were increased, the Apnea-Hypopnea index and severity of OSAS were also significantly elevated. Lastly, the adipose tissue thickness in triceps was positively correlated with the severity of asthma.Conclusions: The prevalence of OSAS was significantly higher in asthma patients than that of normal adult population. According to our results, obese asthmatic patients or asthma patients with large neck diameter should be investigated for the presence of OSAS symptoms. Consequently, polysomnographic examination must be performed in asthma patients with major OSAS symptoms. On the other hand, the absence of snoring may be criteria to exclude OSAS in asthmatic patients. Further studies are required to explore the long term results of coincidence, relation and cross interaction of these two common disorders.Key words: asthma, sleep apnea, obesity, snoring