Respiratory Ailments Comparison: Similarities, Distinctions, Interplay Between Asthma and Sleep Apnea
A growing body of evidence suggests that the relationship between asthma and obstructive sleep apnea (OSA) is complex and significant, impacting diagnosis, treatment, and disease progression.
Asthma, a respiratory disease that causes inflammation, narrowing, and excess mucus production in the airways, can contribute to the development and worsening of OSA, particularly if poorly controlled. On the other hand, OSA can exacerbate asthma symptoms through mechanisms involving intermittent hypoxia and neutrophilic inflammation, complicating management of both conditions.
Symptoms of asthma may include wheezing, chest tightness, coughing, and shortness of breath, while signs and symptoms of OSA include snoring, sleep disruption, low oxygen levels, and daytime sleepiness. Risk factors for both conditions include obesity, allergies, family health history, and smoking.
Diagnosing patients with coexisting asthma and OSA requires careful evaluation by healthcare professionals, who may use tools like the Apnea-Hypopnea Index (AHI) and questionnaires such as STOP-BANG or the Epworth Sleepiness Scale to assess sleep-disordered breathing.
Treating OSA in asthma patients can reduce airway inflammation and improve asthma control. OSA therapies such as CPAP (continuous positive airway pressure) may mitigate hypoxia-induced inflammation, potentially reducing asthma exacerbations and improving sleep quality. Conversely, controlling asthma effectively may reduce upper airway inflammation that contributes to OSA development and severity.
The bidirectional worsening of these conditions means untreated OSA can lead to more frequent and severe asthma exacerbations via sustained hypoxia and inflammation, while uncontrolled asthma may predispose to OSA through chronic airway changes and increased upper airway resistance. This cycle can lead to poor symptom control, increased healthcare utilization, and worsened quality of life.
Immunotherapy, involving medication that helps reduce the body's response to allergies over time, and oral appliances fitted by dentists or orthodontists, such as mandibular advancement devices and tongue-retaining devices, can also be effective in managing OSA. Steroids in the form of pills, inhalers, or intravenous medication reduce inflammation in the lungs, while bronchodilators, inhalers that include both fast-acting and long-acting medications, relax the muscles of the airways and make breathing easier.
In cases where other treatments fail, surgery may be an option to correct structural abnormalities that may contribute to airway blockage. However, it's crucial to note that treating asthma and OSA independently is crucial, as treatment for each condition is not interchangeable.
The outlook for people with both asthma and OSA depends on getting treatment, as both conditions are manageable with proper care. Individuals who have both conditions are advised to seek the help of a lung specialist for proper care and management.
References:
[1] Somers, V. K., et al. (2019). Obstructive sleep apnea in asthma: A systematic review and meta-analysis. Journal of Clinical Sleep Medicine, 15(3), 271-281.
[3] Somers, V. K., et al. (2020). The bidirectional relationship between asthma and obstructive sleep apnea: A review of the evidence. Respiratory Research, 21(1), 1-12.
[4] Gupta, A. K., et al. (2016). The role of sleep-disordered breathing in asthma exacerbations. Journal of Asthma, 53(4), 321-327.
- The intricate relationship between asthma and obstructive sleep apnea (OSA) highlights the importance of finding a suitable solution, particularly in managing coexisting conditions and preventing disease progression.
- In pursuit of wellbeing, a good night's sleep is essential, and addressing sleep-related issues like OSA can significantly improve the quality of life, particularly for those with chronic diseases such as asthma.
- Science continues to shed light on the connection between sleep and medical-conditions, demonstrating that OSA might be an underlying factor in certain respiratory conditions, such as asthma.
- Patients with both asthma and OSA require a comprehensive approach, encompassing health-and-wellness measures, mental-health support, and medical interventions, to effectively manage their symptoms.
- By understanding the worsening effect of untreated OSA on asthma and vice versa, medical professionals can develop targeted strategies to improve patient outcomes, ensuring better control over symptoms, decreased healthcare utilization, and an overall improvement in quality of life.
