Prevalence and predictors of obstructive sleep apnea among patients with bronchial asthma

This study aimed to determine the prevalence, severity, and predictors of OSA among patients with bronchial asthma.

This hospital-based cross-sectional analytical study was conducted over 18 months among 90 adult BA patients diagnosed according to GINA 2019 guidelines. Data collection included a structured questionnaire, clinical examination, spirometry, and the Epworth Sleepiness Scale (ESS). Patients with ESS >10 underwent overnight polysomnography, and OSA severity was assessed using the Apnea-Hypopnea Index (AHI). Bivariate and multivariable analyses were performed to identify predictors of OSA.

OSA was diagnosed in 30 of 90 patients (33.3%). OSA severity was mild in 11 (36.7%), moderate in 15 (50.0%), and severe in 4 (13.3%) patients, with 63.3% having moderate-to-severe disease. Excessive daytime sleepiness (ESS >10) was present in 30.0% of participants, all of whom had PSG-confirmed OSA. AHI showed strong positive correlations with ESS score (r = 0.855), asthma severity (r = 0.641), and asthma duration (r = 0.516) (all p < 0.001). On multivariable analysis, GERD (aOR = 4.62; 95% CI: 1.05-20.33; p = 0.043) and severe asthma (aOR = 52.20; 95% CI: 2.92-932.41; p = 0.007) independently predicted OSA.

OSA is highly prevalent among patients with bronchial asthma, particularly those with severe disease and GERD. Routine sleep assessment may aid in comprehensive asthma management. Larger longitudinal studies are needed to confirm these findings.