Journal
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 201, Issue 11, Pages 1345-1357Publisher
AMER THORACIC SOC
DOI: 10.1164/rccm.201810-1838TR
Keywords
obstructive sleep apnea; asthma; pathophysiology; overlap; continuous positive airway pressure
Categories
Funding
- Clinical Science Research and Development, U.S. Department of Veterans Affairs
- NIH
- Biomedical Laboratory Research and Development, U.S. Department of Veterans Affairs
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Obstructive sleep apnea (OSA) and asthma are highly prevalent chronic respiratory disorders. Beyond their frequent coexistence arising from their high prevalence and shared risk factors, these disorders feature a reciprocal interaction whereby each disease impacts the severity of the other. Emerging evidence implicates airway and systemic inflammation, neuroimmune interactions, and effects of asthma-controlling medications (corticosteroids) as factors that predispose patients with asthma to OSA. Conversely, undiagnosed or inadequately treated OSA adversely affects asthma control, partly via effects of intermittent hypoxia on airway inflammation and tissue remodeling. In this article, we review multiple lines of recently published evidence supporting this interaction. We provide a set of recommendations for clinicians involved in the care of adults with asthma, and identify critical gaps in our knowledge about this overlap.
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