Table 3.
Impact of OSA on asthma severity and control.
| Author | Year | Sample | Definition of OSA | Findings |
|---|---|---|---|---|
| Cross sectional | ||||
| ten Brinke [62] | 2005 | n = 136 difficult-to-treat asthma | PSG or history of snoring and daytime sleepiness with frequent apnea periods of >10 s | ↑ frequent exacerbation OR 3.4 (1.2–10.4) adjusted for age and asthma duration. ↔ frequent exacerbation after accounting for covariates |
| Teodorescu [59] | 2010 | n = 472 outpatient clinic | Sleep Apnea Scale of the Sleep Disorders Questionnaire (high OSA risk vs. without high risk) | ↑ uncontrolled asthma in high OSA risk. OR 2.87 (95% CI 1.54–5.32) accounting for covariates |
| Kim [60] | 2013 | n = 217 outpatient clinic | Berlin questionnaire (high risk vs. low risk) | ↓ asthma specific quality of life score in high OSA risk (vs. low OSA risk) ↔ asthma control |
| Teodorescu [61] | 2013 | n = 813 outpatient clinic | PSG | ↑ worse asthma severity step (OR 2.91, 95% CI 1.15–7.36) ↑ severe asthma (OR 6.67, 95% CI 1.74–25.56) in older subjects (age 60–75) vs. OR 2.61, 95% CI 1.28–5.33) in younger subjects (age 18–59). |
| Tay [63] | 2016 | n = 90 difficult asthma clinic | Berlin questionnaire (high OSA risk vs. low risk) | ↔ frequent exacerbation, ACT score, and asthma-specific quality of life accounting for increasing BMI and other comorbid conditions |
| Ozden Mat [58] | 2021 | n = 137 outpatient clinic | Berlin questionnaire (high OSA risk vs. low risk) | ↑ 7.9 times increased odds of uncontrolled asthma Odds ratio 7.896, 95% CI 2.902–21.487. |
| Longitudinal | ||||
| Jordan [64] | 2015 | n = 2445 World Trade Center Health Registry, 10–11 years follow up | Physician-diagnosed OSA | ↑ 1.39 and 1.48 times increased risk of poorly controlled asthma and very poorly controlled asthma, respectively, adjusting for covariates |
| Wang [65] | 2016 |
n = 146 asthma n = 157 no asthma 1 year follow up |
PSG | ↑ AHI increased risk of severe asthma exacerbations (OR 1.322, 95% CI 1.148–1.523) |
| Yii [66] | 2017 |
n = 177 Step 4 of GINA treatment ladder 5 years follow up |
PSG | ↔ severe asthma exacerbation |
AHI, apnea hypopnea index; BMI, body mass index; CI, confidence interval; OR, odds ratio; OSA, obstructive sleep apnea; PSG, polysomnography; : increased, : decreased, ↔: unchanged.