Continuous positive airway pressure for obstructive sleep apnoea does not improve asthma control
Susanna S.S. Ng
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorTat-On Chan
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorKin-Wang To
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorKen K.P. Chan
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorJenny Ngai
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorWing-Ho Yip
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorRachel L.P. Lo
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorFanny W.S. Ko
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorCorresponding Author
David S.C. Hui
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Correspondence: David S.C. Hui, Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong, China. Email: [email protected]Search for more papers by this authorSusanna S.S. Ng
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorTat-On Chan
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorKin-Wang To
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorKen K.P. Chan
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorJenny Ngai
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorWing-Ho Yip
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorRachel L.P. Lo
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorFanny W.S. Ko
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Search for more papers by this authorCorresponding Author
David S.C. Hui
Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong, China
Correspondence: David S.C. Hui, Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong, China. Email: [email protected]Search for more papers by this authorABSTRACT
Background and objective
Unrecognized obstructive sleep apnoea syndrome (OSAS) may lead to poor asthma control despite optimal therapy. We assessed asthma control, airway responsiveness, daytime sleepiness and health status at baseline and 3 months after continuous positive airway pressure (CPAP) treatment among asthma patients with nocturnal symptoms and OSAS.
Methods
Patients with nocturnal asthma symptoms despite receiving at least moderate-dose inhaled corticosteroid and long-acting bronchodilators underwent a home sleep study using ‘Embletta’ portable diagnostic system. Patients with significant OSAS (apnoea–hypopnoea index (AHI) ≥10/h) were randomized to receive either CPAP or conservative treatment for 3 months.
Results
Among 145 patients recruited, 122 underwent sleep study with 41 (33.6%) having AHI ≥10/h. Patients with significant OSAS had higher BMI (27.4 (5.1) vs 25.1 (4.5) kg/m2, P = 0.016), bigger neck circumference (36.6 (3.1) vs 34.8 (3.6) cm, P = 0.006) and lower minimum SaO2 (80.7 (6.6) vs 87.2 (3.9) %, P < 0.001). Using intention-to-treat analysis among 37 patients with AHI ≥10/h (CPAP group (n = 17) vs control group (n = 20)), there was no significant difference in Asthma Control Test score (CPAP 3.2 (2.7) vs control 2.4 (5.7), P = 0.568) but the CPAP group had a greater improvement in Epworth Sleepiness Scale (−3.0 (4.5) vs 0.5(3.8), P = 0.014), Asthma Quality of Life Questionnaire (0.6 (0.8) vs 0.02 (0.7), P = 0.022) and vitality domain in the SF-36 questionnaire (14.7 (16.8) vs 0.3 (16.2), P = 0.012) after 3 months. Data are presented as mean (SD) unless otherwise stated.
Conclusion
A high prevalence of OSAS was found among patients with asthma and snoring. CPAP therapy for 3 months did not enhance asthma control but improved daytime sleepiness, quality of life and vitality.
Supporting Information
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| resp13363-sup-0001-AppendixS1.docxWord 2007 document , 34.7 KB | Appendix S1 Additional methods. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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