Association between asthma and risk of developing obstructive sleep apnea
- PMID: 25585327
- PMCID: PMC4334115
- DOI: 10.1001/jama.2014.17822
Association between asthma and risk of developing obstructive sleep apnea
Erratum in
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Incorrect Data in Table 4.JAMA. 2015 Jul 7;314(1):86. doi: 10.1001/jama.2015.5464. JAMA. 2015. PMID: 26151279 No abstract available.
Abstract
Importance: Obstructive sleep apnea (OSA) is more common among patients with asthma; whether asthma is associated with the development of OSA is unknown.
Objective: To examine the prospective relationship of asthma with incident OSA.
Design, setting, and participants: Population-based prospective epidemiologic study (the Wisconsin Sleep Cohort Study) beginning in 1988. Adult participants were recruited from a random sample of Wisconsin state employees to attend overnight polysomnography studies at 4-year intervals. Asthma and covariate information were assessed during polysomnography studies through March 2013. Eligible participants were identified as free of OSA (apnea-hypopnea index [AHI] of <5 events/h and not treated) by 2 baseline polysomnography studies. There were 1105 4-year follow-up intervals provided by 547 participants (52% women; mean [SD] baseline age, 50 [8] years).
Exposures: Questionnaire-assessed presence and duration of self-reported physician-diagnosed asthma.
Main outcomes and measures: The associations of presence and duration of asthma with 4-year incidences of both OSA (AHI of ≥5 or positive airway pressure treatment) and OSA concomitant with habitual daytime sleepiness were estimated using repeated-measures Poisson regression, adjusting for confounders.
Results: Twenty-two of 81 participants (27% [95% CI, 17%-37%]) with asthma experienced incident OSA over their first observed 4-year follow-up interval compared with 75 of 466 participants (16% [95% CI, 13%-19%]) without asthma. Using all 4-year intervals, participants with asthma experienced 45 cases of incident OSA during 167 4-year intervals (27% [95% CI, 20%-34%]) and participants without asthma experienced 160 cases of incident OSA during 938 4-year intervals (17% [95% CI, 15%-19%]); the corresponding adjusted relative risk (RR) was 1.39 (95% CI, 1.06-1.82), controlling for sex, age, baseline and change in body mass index, and other factors. Asthma was also associated with new-onset OSA with habitual sleepiness (RR, 2.72 [95% CI, 1.26-5.89], P = .045). Asthma duration was related to both incident OSA (RR, 1.07 per 5-year increment in asthma duration [95% CI, 1.02-1.13], P = .01) and incident OSA with habitual sleepiness (RR, 1.18 [95% CI, 1.07-1.31], P = .02).
Conclusions and relevance: Asthma was associated with an increased risk of new-onset OSA. Studies investigating the mechanisms underlying this association and the value of periodic OSA evaluation in patients with asthma are warranted.
Conflict of interest statement
The authors report no conflicts of interest related to this work.
Comment in
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All about Asthma: Association with Obstructive Sleep Apnea, Management, and Overlap with Chronic Obstructive Pulmonary Disease.Am J Respir Crit Care Med. 2016 Dec 1;194(11):1423-1425. doi: 10.1164/rccm.201605-1061RR. Am J Respir Crit Care Med. 2016. PMID: 27749095 No abstract available.
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