Prevalence of Obstructive Sleep Apnea in Asthma Patients: a Cross-sectional Study

Background: Obstructive sleep apnea (OSA) is a disorder characterized by recurrent upper airway obstructions during sleep, resulting in disrupted airflow lasting at least 10 seconds. Despite its high prevalence and significant comorbidities, OSA remains underdiagnosed, particularly in less developed regions. Asthma, another common respiratory condition, involves persistent airway inflammation leading to symptoms like wheezing, coughing, and chest tightness. The relationship between OSA and asthma is believed to be bidirectional, with each condition potentially influencing the other due to shared risk factors. Furthermore, airway inflammation from either condition can increase the risk of developing the other. Our study aims to investigate the prevalence of OSA among asthma patients in the Syrian community. Methods: The study recruited two groups: one consisting of individuals diagnosed with asthma and the other serving as a control group. The research was conducted at Al-Mouasat Hospital, with the asthma group recruited from the pulmonary clinic and the control group from the internal medicine clinic. Data collection involved the administration of a structured questionnaire through face-to-face interviews with both asthmatic patients and the control group. The Arabic version of the Sleep Apnea Scale of the Sleep Disorders Questionnaire (SDQ-SA) was utilized to assess the risk of obstructive sleep apnea (OSA), while the Asthma Control Questionnaire (ACQ) was employed to evaluate asthma control. Informed consent was obtained from all participants involved in the study, and statistical analysis was performed using SPSS version 22. Results: A total of 276 patients participated in the study, with 111 in the asthma group and 165 in the control group. The two groups were matched for sex and age. It was found that 34.2% of the asthma group indicated a high risk for OSA, whereas only 13.9% of the control group showed a similar risk. The prevalence of OSA was 3.21 times higher in the asthma group compared to the control group. In the subgroup analysis of the asthma group, it was observed that 82.9% of patients had uncontrolled asthma, which was associated with a 12.109-fold higher risk for OSA compared to patients with controlled asthma. Conclusion: Our study revealed a significantly higher prevalence of OSA in asthma patients compared to those without asthma, with uncontrolled asthma showing an even higher risk. Building on these findings and in line with previous research, we recommend heightened awareness and enhanced screening for OSA among individuals with asthma, particularly focusing on those with uncontrolled asthma. Detecting and addressing OSA in this subgroup may lead to a reduction in related health complications and improve the management of both conditions. Clinical trial number: not applicable