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Asthma and obstructive sleep apnea: clinical and pathogenic interactions.
Swathy Puthalapattu1, Octavian C Ioachimescu
1From the *Topeka Veterans Affairs Medical Center, Topeka, KS; and †Atlanta Veterans Affairs Medical Center and Emory University, Atlanta, GA.
Summary
Asthma and obstructive sleep apnea (OSA) share risk factors and can worsen each other. Understanding their complex relationship is key to better managing these common chronic respiratory conditions.
Area of Science:
- Pulmonology and Sleep Medicine
Background:
- Asthma and obstructive sleep apnea (OSA) are prevalent chronic diseases.
- They share risk factors like obesity, smoking, and inflammation.
- The link between asthma and OSA, termed 'alternative overlap syndrome,' is less understood than OSA with COPD.
Purpose of the Study:
- To review the bidirectional relationships between asthma and OSA.
- To explore their clinical, pathophysiologic, and therapeutic connections.
- To propose a framework for understanding these interactions within broader obstructive airway disorders for personalized medicine.
Main Methods:
- Literature review of studies on asthma and OSA.
- Analysis of shared risk factors and pathophysiological mechanisms.
- Discussion of clinical phenotypes and endotypes.
Main Results:
- Coexistence of asthma and OSA has synergistic effects on symptoms, treatment response, and outcomes.
- Both conditions are heterogeneous with diverse clinical phenotypes.
- Further evaluation of disease endotypes is needed for clinical significance.
Conclusions:
- The interaction between asthma and OSA requires deeper investigation into specific etiopathogenic mechanisms and endotypes.
- Reassessing these syndromes within obstructive lung and airway disorders can improve patient stratification.
- Personalized medicine approaches are needed to optimize therapy for patients with coexisting asthma and OSA.
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