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Nocturnal asthma.

Hidenobu Shigemitsu1, Kamyar Afshar

  • 1University of Southern California, Keck School of Medicine, Division of Pulmonary & Critical Care Medicine, Los Angeles, California 90033, USA. hshigemi@usc.edu

Current Opinion in Pulmonary Medicine
|November 30, 2006
PubMed
Summary

Nocturnal asthma symptoms are often missed by physicians, affecting 60% of patients. Treatments like continuous positive airway pressure (CPAP) can improve nighttime symptoms, but not lung function.

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Area of Science:

  • Pulmonology
  • Sleep Medicine
  • Genetics

Background:

  • Nocturnal asthma symptoms are prevalent and often underdiagnosed.
  • Understanding the epidemiology and pathophysiology of nocturnal asthma is crucial for effective management.

Purpose of the Study:

  • To review recent advancements in the epidemiology, pathophysiology, and treatment of nocturnal asthma.

Main Methods:

  • Cross-sectional survey to assess prevalence of nocturnal symptoms.
  • Genetic analysis of beta2-receptor genotype (Gly16 polymorphism).
  • Randomized controlled trials evaluating esomeprazole and continuous positive airway pressure (CPAP).

Main Results:

  • 60% of patients reported nocturnal asthma symptoms, with 42% underdiagnosed.
  • The Gly16 polymorphism was more common in nocturnal asthma patients.
  • Esomeprazole improved peak expiratory flow rate in patients with nocturnal asthma and GERD.
  • Obstructive sleep apnea (OSA) was present in 48% of nocturnal asthma patients with snoring.
  • CPAP improved nocturnal asthma symptoms but not lung function.

Conclusions:

  • Nocturnal asthma symptoms are frequently underdiagnosed.
  • Obstructive sleep apnea and GERD are potential comorbidities.
  • Targeted treatments can alleviate nocturnal asthma symptoms and improve lung function in specific cases.

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