Table 1 Main characteristics of included studies investigating the effect of OSA on lung function and ACT in asthma patients
Author, year, Country | Population with/without OSA | AgeΦ (years) | BMIΦ (kg/cm2) | Male gender (%) | Smoking condition (N or packs/year) | Study design, Quality of study | Severity of asthma | Severity of OSA | Outcomes | Results and implications |
|---|---|---|---|---|---|---|---|---|---|---|
Ciftci et al. 2005 [7] Turkey | N = 22/16 | 44.7 (8.0) | 33.6 (6.5) | 73.7 | N/A | Cohort study, NOS = 7 | Patients who had nighttime symptoms and habitual snoring under optimal medication | AHI ≥ 5/h | %FEV1, FVC%, FEV1/FVC, FEF25–75% | OSA may be a responsible disease for nocturnal symptoms |
Kheirandish-Gozal et al. 2011 [8] USA | N = 58/34 | 6.6 (1.8) | N/A | 53.0 | N/A | Cross-sectional, AHRQ = 7 | Uncontrolled asthma | AHI ≥ 5/h | %FEV1 | The risk of OSA is exceedingly high in poorly controlled asthmatic children. The treatment of OSA appears to be associated with substantial improvements in the severity of the underlying asthmatic condition |
Teng et al. 2014 [9] China | N = 28/23 | 9.4 (1.7) | 18.2 (3.5) | 51.0 | N/A | Cross-sectional, AHRQ = 6 | Routine | AHI ≥ 5/h | %FEV1, FVC%, FEV1/FVC, FEF25–75% | The effect of asthma plus OSA appeared to be sleep disturbance in slow-wave sleep, snoring, respiratory arousal, and leg movement due to respiratory events |
Zidan et al. 2015 [10] Egypt | N = 18/12 | 50.2 (8.4) | 27.4 (4.4) | 43.3 | N/A | Cross-sectional, AHRQ = 5 | Routine | AHI ≥ 5/h | %FEV1 | A suspicion is warranted for the overlap of OSA and asthma, particularly in patients with severe asthma |
Taillé et al. 2016 [11] France | N = 27/28 | 47.8 (1.7) | 28.4 (0.8) | 21.8 | N/A | Cross-sectional, AHRQ = 7 | Uncontrolled asthmatic patients with poor sleep quality, excluding smokers or ex-smokers (> 10 packs/year) | AHI ≥ 5/h | %FEV1, FEV1/FVC, ACT | Mild OSA in patients with severe asthma is associated with the increased proportion of neutrophils in sputum and changes in airway remodeling |
Wang et al. 2017 [12] China | N = 10/67 | 59.9 (13.1) | 26.8 (4.4) | 66.2 | N = 2/22§ | Cross-sectional, AHRQ = 6 | Routine | AHI ≥ 5/h | %FEV1, FEV1/FVC | Asthmatic patients with OSA had substantially greater declines in FEV1 than those without OSA. CPAP treatment alleviated the decline of FEV1 in asthma patients with severe OSA |
Shaker et al. 2017 [13] Egypt | N = 12/38 | 44.9 (10.3) | N/A | 44.0 | Total N = 5 | Cohort study, NOS = 5 | Asthmatic patients with ESS score ≥ 11 | AHI ≥ 5/h | %FEV1, FEV1/FVC | There is a bidirectional relationship between OSA and asthma with increasing frequency of OSA with the increasing asthma severity |
Lu et al. 2017 [14] China | N = 78/45 | 47.6 (12.1) | 26.4 (3.0) | 57.7 | N = 29/8§ | Cross-sectional, AHRQ = 7 | Patients were not in asthma exacerbation within the past 6 months | AHI ≥ 5/h | %FEV1, FVC%, FEV1/FVC, ACT | STOP-Bang questionnaire is a preferable sleep questionnaire better than the Berlin questionnaire for detecting moderate and severe OSA in asthmatic patients |
Yen et al. 2017 [15] Vietnam | N = 56/29 | 9.5 (2.1) | 17.4 (2.8) | 72.8 | Second-hand smoker, Total N = 38 | Cross-sectional, AHRQ = 7 | Routine | Children ≤ 12 years: AHI ≥ 1/h, Children > 12 years: AHI ≥ 5/h | %FEV1, ACT | The presence of allergic rhinitis, snoring, and apnea during sleep in asthmatic children is associated with a higher risk of OSA |
NG et al. 2018 [16] China | N = 41/81 | 50.5 (12.0) | 25.9 (4.8) | 30.3 | OSA group 0.1 (0.6) packs/yearΦ Non-OSA group 0.3 (1.5) packs/yearΦ | Cohort study, NOS = 8 | Uncontrolled asthma | AHI ≥ 15/h | %FEV1, FVC%, ACT | A high risk of OSA was found among patients with asthma and snoring. CPAP therapy for 3 months did not enhance asthma control but improved daytime sleepiness, quality of life, and vitality |
He et al. 2019 [17] USA | N = 41/49 | 11.2 (3.8) | N/A | 57.2 | N/A | Cross-sectional, AHRQ = 7 | Moderate to severe persistent asthma | AHI ≥ 5/h | %FEV1, FVC%, FEV1/FVC, FEF25-75% | OSA in children with moderate to severe persistent asthma is associated with a diminished capacity of the lungs to maintain blood gas homeostasis as measured by plant gain and decreased chemoreceptor sensitivity measured by controller gain |
Oyama et al. 2020 [18] Japan | N = 21/39 | 65.0 (13.4) | 26.5 (4.8) | 20.0 | N/A | Cross-sectional, AHRQ = 7 | Patients with suspected OSA | AHI ≥ 15/h | %FEV1, FEV1/FVC | Patients with high AHI tended to require treatment for serious asthma despite having a good respiratory function |
Lin et al. 2021 [19] China | N = 93/145 | 44.4 (7.1) | 24.4 (3.8) | 53.4 | N/A | Cross-sectional, AHRQ = 7 | Routine | AHI ≥ 5/h | %FEV1, FVC%, FEV1/FVC | Allergic rhinitis, BMI, neck circumference, AHI, SaO2, mPAP, and VEGF are risk factors associated with asthma complicated by OSAHS |