Table 3 Main characteristics of included studies investigating the effect of asthma on PSG and ESS in OSA patients
Author, year, Country | Population with/without asthma | AgeΦ (years) | BMIΦ (kg/cm2) | Male gender (%) | Smoking condition (N or pack year) | Study design, Quality of study | Severity of OSA | Severity of asthma | Outcomes | Results and implications |
|---|---|---|---|---|---|---|---|---|---|---|
Bonay et al. 2003 [27] France | N = 15/22 | 54.0 (11.7) | 36.6 (8.1) | 64.9 | Asthma group 28 (27) pack yearΦ Non-asthma group 9 (17) pack yearΦ | Cross-sectional, AHRQ = 5 | AHI ≥ 15/h | Routine | AHI | Lung function and bronchial responsiveness may be impaired by long-term treatment of OSA by nCPAP. The impairment is observed only in patients with normal initial lung function |
Alharbi et al. 2009 [36] Saudi Arabia | N = 213/393 | 40.0 (14.5) | 36.3 (9.7) | 66.7 | N/A | Cross-sectional, AHRQ = 6 | AHI ≥ 5/h | Routine | AHI, LSpO2, ODI, ArI, ESS | There was a high risk of asthma (35.1%) in patients with OSA as compared to the risk of asthma in the general population |
Ramagopal et al. 2009 [22] USA | N = 22/28 | 9.3 (3.4) | 26.1(11.0) | 64.0 | N/A | Cross-sectional, AHRQ = 6 | AHI ≥ 1/h | Routine | AHI, LSpO2, ArI, | A lifetime history of asthma, extracted from the International Study of Asthma and Allergy in Childhood, was associated with more severe OSA |
Greenberg-Dotan et al. 2014 [30] Israel | N = 96/100 | 56.6 (11.1) | 32.5 (7.0) | N/A | Asthma group 21 (16) pack yearΦ Non-asthma group 29 (13) pack yearΦ | Cross-sectional, AHRQ = 7 | AHI ≥ 5/h | Routine | AHI, ArI, T90% | Patients with asthma and combined COPD/asthma showed no difference in the risks of these co-morbidities between those with and without OSA |
Teng et al. 2014 [9] China | N = 28/28 | 9.5 (1.2) | 17.9 (2.9) | 62.5 | N/A | Cross-sectional, AHRQ = 6 | AHI ≥ 5/h | Routine | AHI, ArI, T90% | 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 |
Zaffanello et al. 2017 [31] Italy | N = 28/98 | 7.8 (4.1) | 21.3 (7.1) | 56.3 | N/A | Cross-sectional, AHRQ = 8 | Not mentioned | Routine | LSpO2, ODI | Children with recurrent wheeze/asthma showed an increased number of central sleep apnea compared to unaffected children |
Bonsignore et a. 2018 [32] Italy | N = 241/5337 | 54.0 (12.2) | 33.9 (8.4) | 80.9 | N/A | Cross-sectional, AHRQ = 8 | AHI ≥ 30/h | Routine | AHI, LSpO2, ODI, ESS | The overall risk of physician-diagnosed asthma was around 5%, with the expected higher risk in women compared with men. The risk of asthma was highest in OSA-free subjects, with a tendency to progressively decrease with increasing OSA severity |
Sundbom et al. 2018 [33] Sweden | N = 15/109 | 55.6 (9.7) | 28.8 (8.5) | 0 | N = 4/38δ | Cross-sectional, AHRQ = 5 | AHI ≥ 15/h | Routine | AHI, ODI, T90% | Co-exist asthma and OSA are associated with poorer sleep quality and more profound nocturnal hypoxemia than either of the conditions alone |
Shrestha et al. 2019 [34] Curacao | N = 223/2599 | 66.0 (11.9) | 29.0 (4.8) | 59.4 | Asthma group 1.42 pack year§ Non-asthma group 1.88 pack year§ | Cross-sectional, AHRQ = 7 | AHI ≥ 5/h | Routine | AHI, ArI, T90%, ESS | OSA was more severe in a non-asthmatic subgroup, and asthmatics had statistically significant higher ESS scores and sleep latency |
Antonaglia et al. 2022 [35] Italy | N = 35/36 | 62.0 (11.0) | 31.2 (14.7) | 73.2 | N/A | Cross-sectional, AHRQ = 8 | AHI ≥ 5/h | Routine | AHI ESS | Asthma may influence the phenotype of OSA by reducing the arousal threshold such that the coexistence of asthma and OSA could be considered a syndrome or a clinical phenotypic trait of OSA |