期刊
JOURNAL OF ASTHMA
卷 49, 期 6, 页码 620-628出版社
TAYLOR & FRANCIS LTD
DOI: 10.3109/02770903.2012.689408
关键词
asthma; asthma control; obstructive sleep apnea; obstructive sleep apnea risk; sleep
资金
- National Institutes of Health [T32 NS007222, MO1 RR00042, 1UL1RR025011]
- University of Wisconsin School of Medicine and Public Health, Medical Education and Research Committee-New Investigator Award
- University of Wisconsin School of Medicine and Public Health Department of Medicine
- University of Michigan Department of Neurology Training Grant [T32 NS007222]
- General Clinical Research Center [MO1 RR00042]
- University of Wisconsin School of Medicine and Public Health
- Medical Education and Research Committee-New Investigator Award
- Department of Medicine
- Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health [1UL1RR025011]
- William S. Middleton Memorial Veteran's Hospital, Madison, Wisconsin
- National Institutes of Health
- Fox Foundation
- GlaxoSmithKline (GSK)
- Bristol Meyer Squib
Objective. Obstructive sleep apnea (OSA) worsens nocturnal asthma, but its potential impact on daytime asthma remains largely unassessed. We investigated whether the sleep disorder is associated with daytime, in addition to nighttime, asthma symptoms. Methods. Asthma patients at tertiary-care centers completed the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ), and an asthma control questionnaire. SA-SDQ scores >= 36 for males and >= 32 for females defined high OSA risk. Medical records were reviewed for established diagnosis of OSA and continuous positive airway pressure (CPAP) use. Results. Among 752 asthma patients, high OSA risk was associated similarly with persistent daytime and nighttime asthma symptoms (p < .0001 for each). A diagnosis of OSA was robustly associated with persistent daytime (p < .0001) in addition to nighttime (p = .0008) asthma symptoms. In regression models that included obesity and other known asthma aggravators, high OSA risk retained associations with persistent daytime (odds ratio [OR] = 1.96 [95% confidence interval [CI] = 1.31-2.94]) and nighttime (1.97 [1.32-2.94]) asthma symptoms. Diagnosed OSA retained an association with persistent daytime (2.08 [1.13-3.82]) but not with nighttime (1.48 [0.82-2.69]) asthma symptoms. CPAP use was associated with lower likelihood of persistent daytime symptoms (0.46 [0.23-0.94]). Conclusions. Questionnaire-defined OSA risk and historical diagnosis were each associated with persistent daytime asthma symptoms, to an extent that matched or exceeded associations with nighttime asthma symptoms. Unrecognized OSA may be a reason for persistent asthma symptoms during the day as well as the night.
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