Predictors of habitual snoring and obstructive sleep apnea risk in patients with asthma

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. Patients with asthma were surveyed at specialty clinics with the Sleep Apnea scale of the Sleep Disorder...

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Published inChest Vol. 135; no. 5; p. 1125
Main Authors Teodorescu, Mihaela, Consens, Flavia B, Bria, William F, Coffey, Michael J, McMorris, Marc S, Weatherwax, Kevin J, Palmisano, John, Senger, Carolyn M, Ye, Yining, Kalbfleisch, Jack D, Chervin, Ronald D
Format Journal Article
LanguageEnglish
Published United States 01.05.2009
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Abstract 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. 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 >or= 36 for men and >or= 32 for women defined high OSA risk. Logistic regression was used to model associations with habitual snoring and high OSA risk. 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. 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.
AbstractList 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. 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 >or= 36 for men and >or= 32 for women defined high OSA risk. Logistic regression was used to model associations with habitual snoring and high OSA risk. 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. 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.
Author Coffey, Michael J
McMorris, Marc S
Bria, William F
Teodorescu, Mihaela
Senger, Carolyn M
Consens, Flavia B
Ye, Yining
Weatherwax, Kevin J
Palmisano, John
Chervin, Ronald D
Kalbfleisch, Jack D
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  surname: Teodorescu
  fullname: Teodorescu, Mihaela
  email: mt3@medicine.wisc.edu
  organization: Department of Medicine and Wisconsin Sleep Institute, University of Wisconsin, Madison, WI; Medical Service and Sleep Disorders Center, William S. Middleton Veterans Hospital, Madison, WI. Electronic address: mt3@medicine.wisc.edu
– sequence: 2
  givenname: Flavia B
  surname: Consens
  fullname: Consens, Flavia B
  organization: Department of Neurology and Sleep Disorders Center, University of Michigan Health System, Ann Arbor, MI
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  givenname: William F
  surname: Bria
  fullname: Bria, William F
  organization: Department of Medicine, University of Michigan Health System, Ann Arbor, MI
– sequence: 4
  givenname: Michael J
  surname: Coffey
  fullname: Coffey, Michael J
  organization: Department of Medicine, University of Michigan Health System, Ann Arbor, MI
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  givenname: Marc S
  surname: McMorris
  fullname: McMorris, Marc S
  organization: Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
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  givenname: Kevin J
  surname: Weatherwax
  fullname: Weatherwax, Kevin J
  organization: Michigan Institute for Clinical and Health Research, University of Michigan Health System, Ann Arbor, MI
– sequence: 7
  givenname: John
  surname: Palmisano
  fullname: Palmisano, John
  organization: Department of Neurology and Sleep Disorders Center, University of Michigan Health System, Ann Arbor, MI
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  givenname: Carolyn M
  surname: Senger
  fullname: Senger, Carolyn M
  organization: Department of Neurology and Sleep Disorders Center, University of Michigan Health System, Ann Arbor, MI
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  givenname: Yining
  surname: Ye
  fullname: Ye, Yining
  organization: Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
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  givenname: Jack D
  surname: Kalbfleisch
  fullname: Kalbfleisch, Jack D
  organization: Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
– sequence: 11
  givenname: Ronald D
  surname: Chervin
  fullname: Chervin, Ronald D
  organization: Department of Neurology and Sleep Disorders Center, University of Michigan Health System, Ann Arbor, MI
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Snippet A high prevalence of obstructive sleep apnea (OSA) symptoms was reported in patients with asthma. Our goal was to evaluate factors associated with habitual...
SourceID pubmed
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StartPage 1125
SubjectTerms Administration, Inhalation
Adolescent
Adrenal Cortex Hormones - administration & dosage
Adult
Aged
Body Mass Index
Body Weight
Comorbidity
Cross-Sectional Studies
Dose-Response Relationship, Drug
Female
Gastroesophageal Reflux - epidemiology
Gastroesophageal Reflux - physiopathology
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Obesity - epidemiology
Prevalence
Risk Factors
Severity of Illness Index
Sleep Apnea, Obstructive - epidemiology
Sleep Apnea, Obstructive - physiopathology
Snoring - epidemiology
Snoring - physiopathology
Surveys and Questionnaires
Young Adult
Title Predictors of habitual snoring and obstructive sleep apnea risk in patients with asthma
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