Revisiting Asthma Obstructive Sleep Apnea Overlap: Current Knowledge and Future Needs

Area of Science:

• Pulmonary Medicine
• Sleep Medicine
• Epidemiology

Background:

• Asthma and obstructive sleep apnea (OSA) are prevalent respiratory conditions with significant health and economic impacts.
• A bidirectional relationship is suggested between asthma and OSA, with shared risk factors and mutual influence.
• Asthma patients frequently report sleep disturbances, including nocturnal symptoms and daytime sleepiness, while OSA prevalence correlates with asthma severity.

Purpose of the Study:

• To review the existing literature on the complex interplay between asthma and obstructive sleep apnea.
• To highlight the impact of each condition on the other and on patient quality of life.
• To identify the need for high-quality research, specifically randomized controlled trials, to clarify causal relationships and treatment effects.

Main Methods:

• Systematic review of epidemiological studies and observational data.
• Analysis of the association between asthma severity and OSA prevalence.
• Examination of the impact of OSA on asthma exacerbations and control.

Main Results:

• Increasing asthma severity is linked to a higher prevalence of OSA.
• OSA is associated with worse asthma control, increased exacerbations, and diminished quality of life.
• Asthma may influence OSA by lowering arousal thresholds, potentially leading to specific phenotypes.

Conclusions:

• The relationship between asthma and OSA is bidirectional and complex, affecting disease severity and patient outcomes.
• Current evidence relies heavily on observational studies, necessitating further investigation.
• Randomized controlled trials are crucial to establish causality and guide therapeutic strategies for patients with comorbid asthma and OSA.