Predictors of Habitual Snoring and Obstructive Sleep Apnea Risk in Patients With Asthma
Autor: | Carolyn M. Senger, Mihaela Teodorescu, John Palmisano, Flavia B. Consens, Michael J. Coffey, Ronald D. Chervin, William F. Bria, Yining Ye, Marc S. McMorris, Kevin J. Weatherwax, John D. Kalbfleisch |
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Rok vydání: | 2009 |
Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Comorbidity Critical Care and Intensive Care Medicine Severity of Illness Index Body Mass Index Young Adult Adrenal Cortex Hormones Risk Factors Surveys and Questionnaires Internal medicine Administration Inhalation Epidemiology Prevalence medicine Humans Obesity Risk factor Aged Asthma Sleep Apnea Obstructive Dose-Response Relationship Drug business.industry Body Weight Snoring Sleep apnea Odds ratio Middle Aged medicine.disease nervous system diseases respiratory tract diseases Obstructive sleep apnea Cross-Sectional Studies Logistic Models Apnea–hypopnea index Multivariate Analysis Gastroesophageal Reflux GERD Physical therapy Female Cardiology and Cardiovascular Medicine business |
Zdroj: | Chest. 135:1125-1132 |
ISSN: | 0012-3692 |
Popis: | Background A high prevalence of obstructive sleep apnea (OSA) symptoms was reported in patients with asthma. Our goal was to evaluate factors associated with habitual snoring and OSA risk in these patients. Methods Patients with asthma were surveyed at specialty clinics with the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) and questions about the frequency of asthma symptoms (National Asthma Education and Prevention Program guidelines), followed by medical record review. SA-SDQ scores ≥ 36 for men and ≥ 32 for women defined high OSA risk. Logistic regression was used to model associations with habitual snoring and high OSA risk. Results Among 244 patients, 37% snored habitually and 40% demonstrated high OSA risk. Independent predictors of habitual snoring included gastroesophageal reflux disease (GERD) [odds ratio (OR), 2.19; 95% confidence interval (CI), 1.19 to 4.02] and use of an inhaled corticosteroid (ICS) [OR, 2.66; 95% CI, 1.05 to 6.72]. High OSA risk was predicted by asthma severity step (OR, 1.59; 95% CI, 1.23 to 2.06), GERD (OR, 2.70; 95% CI, 1.51 to 4.83), and ICS use (OR, 4.05; 95% CI, 1.56 to 10.53). Linear, dose-dependent relationships of ICS with habitual snoring and high OSA risk were seen (p = 0.004 and p = 0.0006, respectively). Women demonstrated a 2.11 times greater odds for high OSA risk (95% CI, 1.10 to 4.09) when controlling for the above covariates. Conclusions Symptoms of OSA in patients with asthma are predicted by asthma severity, coexistent GERD, and use of an ICS in a dose-dependent fashion. The well-recognized male gender predominance for OSA symptoms is not apparent in these patients. Further exploration of these relationships may help to explain the increased prevalence of OSA in asthma and provide new insights into the reported female predominance of asthma morbidity. |
Databáze: | OpenAIRE |
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