Severe Asthma ToolkitSevere Asthma Toolkit
HomeAboutSpecific PopulationsRegistriesContributorsContact
Twitter
  • What is Severe Asthma?
    • Overview
    • Definition
    • Prevalence & Burden
    • Pathophysiology
    • Symptoms
    • Severe Asthma Attacks / Exacerbations / Flare-ups
    • Asthma Phenotypes
  • Diagnosis & Assessment
    • Overview
    • Diagnosis Overview
    • Assessment Overview
    • Lung Function Assessments
    • Questionnaires
    • Allergy Assessments
    • Phenotyping
    • Bronchoscopy
    • Imaging
    • Occupational Asthma
  • Management
    • Overview
    • Asthma Education
      • About Severe Asthma
      • Asthma Pathophysiology
      • Medications Education
      • Self-Monitoring
      • Triggers
      • Review
    • Written Action Plans
    • Adherence
    • Inhaler Technique
    • Physical Activity & Exercise
    • Interdisciplinary Approach & Multidimensional Assessment
    • Referral
  • Medications
    • Overview
    • Relievers
    • Preventers / Controllers
    • Add-on Therapies
    • Monoclonal Antibodies
    • Bronchial Thermoplasty
  • Co-Morbidities
    • Overview
    • Pulmonary & Upper Airways
      • Allergic & Non-Allergic Rhinitis
      • Chronic Rhinosinusitis
      • Dysfunctional Breathing
      • Vocal Cord Dysfunction
      • Chronic Obstructive Pulmonary Disease
      • Bronchiectasis
      • Obstructive Sleep Apnoea
    • Extra-Pulmonary
      • Obesity
      • Anxiety & Depression
      • Gastro-oesophageal Reflux Disease (GORD)
      • Osteoporosis
      • Cardiovascular Disease & Metabolic Disease
  • Living with Severe Asthma
    • Overview
    • Daily Symptom Burden
    • Mental & Emotional Health
    • Intimacy & Relationships
    • Self-Management Support
    • Medication Use & Costs
    • Experience of Care
    • Experience of Asthma Attacks
    • Prognosis
  • Establishing a Clinic
    • Overview
    • Set-up
    • Staffing & Multidisciplinary Team Approach
    • Facilities
    • Delivery Approach
    • Tailored Referrals
    • Evaluation
    • Opportunities for Training & Research
    • Barriers & Hurdles
  • Paediatrics
    • Overview
    • Management in Paediatrics
    • Assessment in Paediatrics
    • Alternative Diagnosis & Co-Morbidities in Paediatrics
    • Psychosocial Issues in Paediatrics
    • Medications in Paediatrics
    • Asthma in the Adolescent Population
  • Resources
    • Overview
    • Clinic Recommendations
    • Infographics
    • Asthma Assessment Resources
    • Systematic & Multidimensional Assessment Resources
      • Airway Components
      • Comorbidity Components
      • Risk Factor Components
    • Translation & Implementation
    • Case Studies
    • Presentations
    • Videos
    • Relevant Links
    • Key References

Obstructive Sleep Apnoea

Home Co-Morbidities Pulmonary & Upper Airways Obstructive Sleep Apnoea
young girl sleeping with Obstructive Sleep Apnoea

Obstructive Sleep Apnoea Impacts:

  • Poor asthma control
  • Increased healthcare utilization
  • Increased medication use
  • Impaired quality of life

Obstructive sleep apnoea (OSA) is characterised by repetitive collapse of the upper airway resulting in snoring, intermittent oxygen desaturations, sleep arousal, and excessive daytime sleepiness (Young et al. 1993).  The severity of OSA is described by the apnoea hyponoea index (AHI). The community prevalence of at least moderate OSA (AHI >15) in reported to be approximately 15% in men and 5% in women (Peppard et al. 2013).  The prevalence of OSA is rising, due to the increasing rates of obesity.

Prevalence

The true prevalence of OSA in asthma patients has been poorly studied. In a study of 52 patients with asthma and 26 matched controls, at least moderate OSA was found in 88% of patients with severe asthma and 58% of patients with moderate asthma, compared with 31% of controls (Julien et al. 2009). Yigla et al performed sleep studies on 22 patients with severe asthma and reported at least moderate OSA in 51% (Yigla et al. 2003).

Questionnaire data from a severe asthma cohort demonstrated that 26% of patients with severe asthma were at high risk of OSA, compared with 3% of controls (Teodorescu et al. 2015). Community based epidemiological studies have demonstrated that people with asthma are at increased risk of subsequently developing obstructive sleep apnoea (Shen et al. 2015, Teodorescu et al. 2015).

Prevalence rates of obstructive sleep apnoea assessed by sleep studies:
People with severe asthma 88%
88%
People with moderate asthma 58%
58%
Control population 31%
31%
Prevalence rates of obstructive sleep apnoea assessed by questionnaires:
People with severe asthma at high-risk 26%
26%
Controls 3%
3%

Data represented from (Julien et al. 2009, Yigla et al. 2003, Teodorescu et al. 2015)

Effect on Asthma

OSA may lead to poor asthma control, increased healthcare utilisation, increased beta-agonist use and lower quality of life (Teodorescu et al. 2015, Tay et al. 2016). However, it should be noted that a smaller study of patients who underwent a sleep study, there was no association between OSA and poor asthma control (Julien et al. 2009).

The interaction between OSA and poor asthma control is not understood.  Possible mechanisms include neutrophilic airway inflammation (Teodorescu et al. 2015) and increased vagal tone contributing to airway hyper-responsiveness (Guilleminault et al. 1988).

Treatment

There is some weak evidence to suggest that CPAP use could improve asthma control.  Treatment of patients with severe OSA and co-existent asthma for 6 weeks, resulted in significant improvements in asthma related quality of life (Lafond et al. 2007).  In a small randomised controlled trial comparing therapeutic CPAP to sham-CPAP, 7 nights of therapeutic CPAP was also found to significantly reduce bronchial hyper-responsiveness (Busk et al. 2013).

Previous
Next

Last Updated on February 12, 2019

Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories

More results...

  • Overview
  • Pulmonary & Upper Airways
    • Allergic & Non-Allergic Rhinitis
    • Chronic Rhinosinusitis
    • Dysfunctional Breathing
    • Vocal Cord Dysfunction
    • Chronic Obstructive Pulmonary Disease
    • Bronchiectasis
    • Obstructive Sleep Apnoea
  • Extra-Pulmonary
    • Obesity
    • Anxiety & Depression
    • Gastro-oesophageal Reflux Disease (GORD)
    • Osteoporosis
    • Cardiovascular Disease & Metabolic Disease
For considerations relevant to the paediatric and adolescent population, please see Alternative Diagnoses & Co-Morbidities in Paediatrics or Asthma in the Adolescent Population

We want to know who accesses the Severe Asthma Toolkit and how it is used. Please complete our survey.

Responses will inform the continued development of the Severe Asthma Toolkit and future translation and implementation activities. Any feedback you provide will be greatly appreciated.

Complete Survey

  • Website Terms of Use
  • Website Survey
© Copyright 2018    CRICOS Provider Number 00109J    The University of Newcastle, Australia