Clinical and Sleep Characteristics and the Effect of CPAP Treatment on Obese Patients with Obstructive Sleep Apnea...

Patients with obstructive sleep apnea (OSA) and asthma share common symptoms and risk factors.

The aim of this study is to evaluate the clinical characteristics of patients with OSA and asthma and assess the impact of CPAP treatment on asthma control and exacerbations.

Consecutive patients diagnosed with concomitant OSA and asthma were enrolled in the study. Data on patients' characteristics, respiratory function during wakefulness, and polysomnography were recorded. Additionally, asthma control and exacerbation history were assessed the year before and after initiation of CPAP therapy.

The cohort included 102 patients (53 men and 49 women; mean age 56.5 ± 12.8 years). The severity of OSA was classified as severe in 49%, moderate in 27.5%, and mild in 23.5% of patients. The most common comorbidities were arterial hypertension (66.7%) and dyslipidemia (52%). Before CPAP initiation, most patients (55.9%) had moderate asthma control (ACT score 17.4 ± 0.9). Following CPAP treatment, the ACT score was improved (p < 0.001) and asthma exacerbations were significantly reduced (p = 0.002). Moreover, the Asthma Control Test (ACT) score was negatively correlated with BMI (r = -0.209, p = 0.035), AHI (r = -0.426, p < 0.001), oxygen desaturation index (r = -0.466, p < 0.001), and percentage of sleep time with oxygen saturation <90% (T < 90%) (r = -0.228, p = 0.021). Also, patients who experienced exacerbations (44/102) had higher AHI (p = 0.022) and more severe nocturnal hypoxia (T < 90%, p = 0.016).

Asthma control is associated with OSA severity and BMI, while CPAP therapy seems to improve asthma control and reduces exacerbations in patients with concomitant OSA and asthma.