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Association of Obstructive Sleep Apnea Risk with Asthma Control in Adults.

Chest. 2010 May 21 Teodorescu M, Polomis DA, Hall SV, Teodorescu MC, Gangnon RE, Peterson AG, Xie A, Sorkness CA, Jarjour NN. Medical Service, William S. Middleton Memorial Veteran's Hospital;

BACKGROUND: Unrecognized obstructive sleep apnea (OSA) may lead to poor asthma control despite optimal therapy. Our objective was to evaluate the relationship between OSA risk and asthma control in adults.

METHODS: Asthma patients at routine tertiary care clinic visits completed the validated Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) and Asthma Control Questionnaire (ACQ). ACQ >/=1.5 defined not well controlled asthma, and SA-SDQ >/=36 for men and >/=32 for women defined high OSA risk. Logistic regression was used to model associations of high OSA risk with not well controlled asthma (ACQ full and short versions).

RESULTS: Among 472 subjects with asthma, the mean ACQ (full version) score was 0.87+/-0.90 and 80 subjects (17%) were not well controlled. Mean SA-SDQ score was 27+/-7, and 109 subjects (23%) met the definition of high OSA risk. High OSA risk was associated on average with 2.87 times higher odds for not well controlled asthma (ACQ full version) (95% confidence interval [1.54-5.32], p=0.0009), after adjusting for obesity and other factors known to worsen asthma control. Similar independent associations were seen when using the short ACQ versions.

CONCLUSIONS: High OSA risk is significantly associated with not well controlled asthma, independent of known asthma aggravators and regardless of the ACQ version used. Patients who have difficulty achieving adequate asthma control should be screened for OSA.

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