. 2020 Jun 1;201(11):1345–1357. doi: 10.1164/rccm.201810-1838TR

Table 2.

Impact of Obstructive Sleep Apnea on Asthma: Epidemiologic and Clinical Studies

Reference	Sample	Assessment and Exclusion of Treated Patients with OSA	Results
Cross-sectional studies

ten Brinke et al., 2005 (8)	n = 136	OSA: symptoms or PSG; OSA treatment not reported	• ↑ Asthma exacerbation in OSA; adjusted OR, 3.4^*
ten Brinke et al., 2005 (8)	Pulmonary clinic	Asthma: severe, one or more exacerbations/yr or OCS use	• ↑ Asthma exacerbation in OSA; adjusted OR, 3.4^*

Teodorescu et al., 2013 (7)	Age 18–59 yr, n = 659	OSA: PSG (medical records); treated OSA excluded	• ↑ Severe asthma in the older age group with OSA; OR, 6.7^*
	Age 60–75 yr, n = 154	Asthma: NAEPP classification of asthma severity
	Pulmonary and allergy clinics	Asthma: NAEPP classification of asthma severity

Kim et al., 2013 (93)	n = 217	OSA: Berlin Questionnaire; treated OSA excluded	• ↓ Asthma disease-specific quality of life in high-risk OSA
Kim et al., 2013 (93)	Specialty clinic	Asthma: physician diagnosis and airway reversibility on spirometry

Tay et al., 2016 (94)	n = 90	OSA: Berlin or PSG; OSA treatment not specified	• OSA not associated with asthma exacerbations or quality of life after adjustment for obesity
Tay et al., 2016 (94)	Asthma clinic	Asthma: referred for difficult asthma

Longitudinal studies

Jordan et al., 2015 (95)	n = 2,445	OSA: self-reported physician diagnosis; OSA treatment not specified	• ↑ Risk of poorly controlled asthma in OSA; OR, 1.4–1.5^*
	Prospective cohort study	Asthma: physician-diagnosed incident asthma after 9/11, modified NAEPP classification of asthma severity
	World Trade Center Health Registry

Wang et al., 2016 (64)	Asthma, n = 146	OSA: PSG; treated OSA excluded	• AHI associated with ↑ risk of severe asthma exacerbation; OR, 1.3^*
	No asthma, n = 157	Asthma: spirometry or MCT
	Prospective case control	Asthma: spirometry or MCT

Yii et al., 2017 (96)	n = 177	OSA: PSG; OSA treatment not specified	• No significant ↑ risk of severe asthma exacerbations in OSA
Yii et al., 2017 (96)	Prospective clinical cohort, 5-yr follow-up	Asthma: step 4 of GINA treatment

Definition of abbreviations: ↓ = decreased; ↑ = increased; AHI = apnea–hypopnea index; CPAP = continuous positive airway pressure; GINA = Global Initiative for Asthma; MCT = methacholine challenge test; NAEPP = National Asthma Education and Prevention Program; OCS = oral corticosteroid; OR = odds ratio; OSA = obstructive sleep apnea; PSG = polysomnography.

Statistically significant OR.