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. 2019 Dec;24(12):1176-1182.
doi: 10.1111/resp.13576. Epub 2019 May 8.

Nocturnal symptoms perceived as asthma are associated with obstructive sleep apnoea risk, but not bronchial hyper-reactivity

Chamara V Senaratna  1   2 , E Haydn Walters  3 , Garun Hamilton  4   5 , Adrian J Lowe  1 , Caroline Lodge  1 , John Burgess  1 , Bircan Erbas  6 , Graham G Giles  7   8   9 , Paul Thomas  10 , Michael J Abramson  7 , Bruce Thompson  11 , Jennifer L Perret  1 , Shyamali C Dharmage  1
Affiliations

Nocturnal symptoms perceived as asthma are associated with obstructive sleep apnoea risk, but not bronchial hyper-reactivity

Chamara V Senaratna et al. Respirology. 2019 Dec.

Abstract

Background and objective: Obstructive sleep apnoea (OSA) and asthma are associated, and nocturnal breathing difficulty that is usually identified as asthma-like symptoms can be present in both conditions. We investigated how nocturnal asthma-like symptoms (NAS) and bronchial hyper-reactivity (BHR) contribute to the association between OSA risk and current asthma, which is currently unknown but a clinically important question.

Methods: We used data from 794 middle-aged participants in a population-based cohort who provided information on OSA risk (defined by a STOP-Bang questionnaire score of at least 3), current asthma and NAS, and underwent methacholine bronchial challenge testing. Using regression models, we examined the association between OSA risk and current asthma-NAS subgroups and investigated any effect modification by BHR.

Results: The participants were aged 50 years (49.8% male). OSA risk was associated with NAS with or without current asthma (odds ratio (OR): 2.6; 95% CI = 1.3-5.0; OR: 4.2; 95% CI = 1.1-16.1, respectively), but not with current asthma in the absence of NAS. BHR was associated with current asthma with or without NAS (OR: 2.9; 95% CI = 1.4-5.9; OR: 3.4; 95% CI = 2.0-7.0, respectively) but not with NAS in the absence of current asthma. The associations between OSA risk and current asthma were neither modified nor mediated by BHR.

Conclusion: Our findings suggest that some of the nocturnal symptoms perceived as asthma may be OSA symptoms. Patients with nocturnal asthma symptoms should be considered for possible OSA.

Keywords: airway resistance; asthma; bronchial hyper-reactivity; sleep apnoea syndromes; sleep apnoea, obstructive.

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Comment in

  • All that wheezes at night is not asthma.
    Sunwoo BY, Owens RL. Sunwoo BY, et al. Respirology. 2019 Dec;24(12):1127-1128. doi: 10.1111/resp.13622. Epub 2019 Jun 13. Respirology. 2019. PMID: 31195427 No abstract available.

References

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