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European Journal of Medical Research
Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Sleep Apnea | Review

The relationship between obstructive sleep apnea and asthma severity and vice versa: a systematic review and meta-analysis

Authors: Donghao Wang, Yanyan Zhou, Riken Chen, Xiangxia Zeng, Sun Zhang, Xiaofen Su, Yateng Luo, Yongkang Tang, Shiwei Li, Zhiyang Zhuang, Dongxing Zhao, Yingying Ren, Nuofu Zhang

Published in: European Journal of Medical Research | Issue 1/2023

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Abstract

Background

There is a great association between the prevalence of obstructive sleep apnea (OSA) and asthma. Nonetheless, whether OSA impacts lung function, symptoms, and control in asthma and whether asthma increases the respiratory events in OSA are unknown. This meta-analysis aimed to examine the relationship between obstructive sleep apnea and asthma severity and vice versa.

Methods

We carried out a systematic search of PubMed, EMBASE, and Scopus from inception to September 2022. Primary outcomes were lung function, parameters of polysomnography, the risk of OSA in more severe or difficult-to-control asthmatic patients, and the risk of asthma in patients with more severe OSA. Heterogeneity was examined with the Q test and I2 statistics. We also performed subgroup analysis, Meta-regression, and Egger’s test for bias analysis.

Results

34 studies with 27,912 subjects were totally included. The results showed that the comorbidity of OSA aggravated lung function in asthmatic patients with a consequent decreased forced expiratory volume in one second %predicted (%FEV1) and the effect was particularly evident in children. %FEV1 tended to decrease in adult asthma patients complicated with OSA, but did not reach statistical significance. Interestingly, the risk of asthma seemed to be slightly lower in patients with more severe OSA (OR = 0.87, 95%CI 0.763–0.998). Asthma had no significant effect on polysomnography, but increased daytime sleepiness assessed by the Epworth Sleepiness Scale in OSA patients (WMD = 0.60, 95%CI 0.16–1.04). More severe asthma or difficult-to-control asthma was independently associated with OSA (odds ratio (OR) = 4.36, 95%CI 2.49–7.64).

Conclusion

OSA was associated with more severe or difficult-to-control asthma with decreased %FEV1 in children. The effect of OSA on lung function in adult patients should be further confirmed. Asthma increased daytime sleepiness in OSA patients. More studies are warranted to investigate the effect of asthma on OSA severity and the impact of different OSA severity on the prevalence of asthma. It is strongly recommended that people with moderate-to-severe or difficult-to-control asthma screen for OSA and get the appropriate treatment.
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Metadata
Title
The relationship between obstructive sleep apnea and asthma severity and vice versa: a systematic review and meta-analysis
Authors
Donghao Wang
Yanyan Zhou
Riken Chen
Xiangxia Zeng
Sun Zhang
Xiaofen Su
Yateng Luo
Yongkang Tang
Shiwei Li
Zhiyang Zhuang
Dongxing Zhao
Yingying Ren
Nuofu Zhang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-01097-4

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