Prevalence and Clinical Appearance of Obstructive Sleep Apnea (OSA) Among Asthma Patients

Studies on respiratory disorders show decreased sleep quality in asthma patients possibly due to nocturnal asthma symptoms. Recent studies show that OSA is related to bronchial hyperresponsiveness and may be related to asthma. In this observational study, asthma patients who visited Persahabatan Hospital asthma clinic from May 2009 to February 2010 was recruited consecutively. Spirometry and bronchial provocation test (4.5% hyper saline) was performed. OSA was evaluated using Berlin Questionnaire and polysomnography. Anatomical evaluation related to OSA/asthma risk factor or comorbid were performed by one ENT specialist. Diagnosis of OSA was discovered in 20 out of 101 subjects (19.8%) using Berlin questionnaire and 9.8% using polysomnography. The main OSA symptoms found were snoring, fatigue after sleeping, and daytime sleepiness. OSA patient shave higher BMI (28.54kg/m2 vs 21.48kg/m2; p<0.05); larger neck circumference (37.90 cm vs 33.6 cm; p=0.01 OR=2.8 CI=1.28-6.01), decreased FEV1 (56.70% pred vs 59.51% pred). In asthma patients with OSA, 18 (90%) have anatomical upper airway disorder such as septum deviation, sinusitis, adenoid, concha hyperthrophy and long uvula. In conclusion asthma patients have higher prevalence of OSA compared to the general population using both methods. The risk of OSA in asthma are correlated with increased BMI, neck circumference. The main OSA symptom found in asthma patients is snoring.