Table 3.

Effects of Treatment for Obstructive Sleep Apnea on Asthma Outcomes

Reference	Design/Sample	Assessment	Results	Limitations
CPAP treatment
Teodorescu et al., 2012 (62)	Cross-sectional	OSA: SA-SDQ and PSG	• ↓ Daytime asthma symptoms (*OR, 0.46)	Objective CPAP adherence not available
	n = 132 with OSA, 75 on CPAP	Asthma: physician diagnosis
Teodorescu et al., 2013 (7)	Cross-sectional	OSA: PSG	• ↓ Risk of severe asthma (more in older vs. younger patients, by 91% vs. 57%)	PSG-derived OSA severity or objective CPAP adherence not available
	Age 18–59 yr vs. 60–75 yr	Asthma: physician diagnosis
	n = 140
Kauppi et al., 2016 (97)	Longitudinal, retrospective study	OSA: physician diagnosis and CPAP ≥3 mo	• ↓ Asthma severity (ACT and VAS)	Generalizability limited with high CPAP adherence (6.3 h daily)
	n = 152	Asthma: on asthma medication
Wang et al., 2017 (63)	Longitudinal, retrospective study	OSA: PSG	• ↓ The annual decline in FEV1 in severe OSA	No control group
	n = 77	Asthma: spirometry
Lafond et al., 2007 (68)	Interventional: CPAP × 6 wk	OSA: PSG (AHI ≥ 15/h) and CPAP titration	• No difference in methacholine challenge test	Per-protocol analysis of 13 patients with ≥4 h daily CPAP use
	n = 20	Asthma: ATS criteria	• ↑ Asthma-specific quality of life
Serrano-Pariente et al., 2017 (69)	Interventional: CPAP × 6 mo	OSA: AHI ≥20/h	• ↑ Asthma control, disease-specific quality of life	No control group
	n = 99	Asthma: physician diagnosis	• ↓ Bronchial reactivity (reduced proportion of patients with positive bronchodilator response), exhaled NO
Other OSA treatments
Bachour et al., 2016 (71)	Cross-sectional survey, n = 303	OSA: referred for oral appliance treatment	• ↑ ACT with oral appliance treatment	No control group
	Asthma, n = 18	Asthma: physician diagnosis and asthma medication use
Omana et al., 2010 (73)	Retrospective bariatric cohort	OSA: CPAP use	• Self-reported improvement in symptoms or cessation of treatment; in asthma 21/31, in OSA 14/32	Lack of validated questionnaire
	Follow-up 17 mo, n = 123
	Asthma, n = 31	Asthma: use of asthma medications
	OSA, n = 32
Simard et al., 2004 (72)	Prospective bariatric cohort	OSA: self-reported	• Self-reported improvement in asthma control in 23/34	Lack of validated questionnaire
	Follow-up 2 yr, n = 398	Asthma: self-reported
	Asthma, n = 34
	OSA, n = 47
	OSA and asthma, n = 18

Definition of abbreviations: ↓ = decreased; ↑ = increased; ACT = asthma control test; AHI = apnea–hypopnea index; ATS = American Thoracic Society; CPAP = continuous positive airway pressure; OR = odds ratio; OSA = obstructive sleep apnea; PSG = polysomnography; SA-SDQ = sleep apnea scale of the Sleep Disorders Questionnaire; VAS = visual analog scale.

^*Statistically significant OR.