Table 4.
Key Research Questions Emerging from Current Evidence
| Direction of the Interaction | Key Questions |
|---|---|
| Asthma→OSA | • Natural history of the interaction, starting early in life (e.g., during pregnancy in birth cohorts), and the role of sex in this relationship |
| • Relationship of asthma clinical/inflammatory phenotypes with OSA incidence | |
| • Mechanistic studies of effects of asthma and related features on OSA phenotypic traits (loop gain, arousal threshold, pharyngeal upper-airway collapsibility) | |
| • Role of inhaled corticosteroids in upper-airway patency during sleep and other relevant functions (swallowing and speech) | |
| • Comparative effectiveness of screening algorithms and diagnostic tools for OSA in patients with asthma | |
| OSA→asthma | • Role of other OSA features (i.e., “mechanical stress” and sleep fragmentation) in modulating asthmatic airways |
| • Reliability of home sleep apnea tests in asthma clinical/inflammatory phenotypes | |
| • Whether asthma should be an indication for CPAP treatment in mild OSA | |
| • Role of OSA in responsiveness of asthma to various therapies | |
| • Role of other OSA treatment modalities in asthma burden | |
| • Randomized controlled trials on effects of PAP or other therapies for OSA on patient-centric asthma outcomes and determinants (sex and other variables) of response | |
| • Role of OSA in the management algorithms for asthma |
Definition of abbreviations: CPAP = continuous positive airway pressure; OSA = obstructive sleep apnea; PAP = positive airway pressure.