Does Continuous Positive Airway Pressure (CPAP) treatment of obstructive sleep apnoea (OSA) improve asthma-related clinical outcomes in patients with co-existing conditions?- A systematic review

Research output: Contribution to journalArticlepeer-review

Authors

  • Sarah Davies
  • Abigail Bishopp
  • Simon Wharton
  • Alice Turner
  • Adel Mansur

External organisations

  • Birmingham Heartlands Sleep Service, Heart of England NHS Trust

Abstract

Introduction: A high prevalence of OSA has been observed in asthma populations, with detrimental impact on clinical outcomes.


Aim: To determine if CPAP treatment of co-existing OSA improves asthma-related symptoms and quality of life.


Methods: Literature review of EMBASE and MEDLINE databases prior to July 2017. Study populations included asthmatics with co-existing OSA treated with CPAP, and ≥1 asthma-related clinical outcome measure.


Results: 12 studies; 8 prospective quasi-experimental and 4 observational. Mean CPAP duration; 19.5 (2–100) weeks. Meta-analysis demonstrated significant improvement in mean Asthma Quality of Life Questionnaire scores (AQLQ and mini-AQLQ); 0.59 (95%CI; 0.25, 0.92), p = 0.0006. No significant improvement was demonstrated in forced expiratory volume in 1 s (FEV1)% predicted; 0.32 (95%CI; −2.84, 3.47), p = 0.84. Asthma Control Test/Asthma Control Questionnaire improved in 2 studies, with no improvement in 1 study. 4 studies demonstrated improvement in asthma daytime/night-time symptoms, and 3 studies showed improved asthma severity.


Conclusion: Asthmatics with co-existing OSA can experience improved quality of life with CPAP treatment. This effect appears more pronounced in severe OSA or poorly controlled asthma.

Details

Original languageEnglish
Pages (from-to)18-30
JournalRespiratory Medicine
Volume143
Early online date9 Aug 2018
Publication statusPublished - 1 Oct 2018

Keywords

  • asthma, obstructive sleep apnoea, OSA, CPAP, continuous positive airway pressure