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Original Research: ASTHMA |

Association of Obstructive Sleep Apnea Risk With Asthma Control in Adults

Mihaela Teodorescu, MD, FCCP; David A. Polomis, MD; Stephanie V. Hall, MPH; Mihai C. Teodorescu, MD; Ronald E. Gangnon, PhD; Andrea G. Peterson, MS; Ailiang Xie, PhD; Christine A. Sorkness, PharmD; Nizar N. Jarjour, MD, FCCP
Author and Funding Information

From the Medical Service (Drs M. Teodorescu and M. C. Teodorescu), William S. Middleton Memorial Veterans Hospital; Section of Allergy, Pulmonary and Critical Care Medicine (Drs M. Teodorescu, Polomis, Xie, Sorkness, and Jarjour and Mss Hall and Peterson); Wisconsin Sleep Institute (Drs. M. Teodorescu and M. C. Teodorescu); Section of Geriatrics and Gerontology (Dr M. C. Teodorescu); Department of Biostatistics and Medical Informatics and Population Health Sciences (Dr Gangnon), University of Wisconsin School of Medicine and Public Health; and University of Wisconsin School of Pharmacy (Dr Sorkness), Madison, WI.

Correspondence to: Mihaela Teodorescu, MD, FCCP, University of Wisconsin School of Medicine and Public Health, K4/910 CSC 9988, 600 Highland Ave, Madison, WI 53792-9988; e-mail: mt3@medicine.wisc.edu


Funding/Support: This work was performed at the University of Wisconsin–Madison and was funded by the University of Wisconsin School of Medicine and Public Health, Department of Medicine, and Medical Education and Research Committee–New Investigator Award; 1UL1RR025011 from the Clinical and Translational Science Award program of the National Center for Research Resources, National Institutes of Health; and additional resources from the William S. Middleton Memorial Veterans Hospital, Madison, WI (to Dr M. Teodorescu).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(3):543-550. doi:10.1378/chest.09-3066
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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:  Patients with asthma seen routinely at tertiary-care clinic visits completed the validated Sleep Apnea Scale of the Sleep Disorders Questionnaire (SA-SDQ) and Asthma Control Questionnaire (ACQ). An ACQ score of ≥ 1.5 defined not-well-controlled asthma, and an SA-SDQ score of ≥ 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 version and short versions).

Results:  Among 472 subjects with asthma, the mean ± SD ACQ (full version) score was 0.87 ± 0.90, and 80 (17%) subjects were not well controlled. Mean SA-SDQ score was 27 ± 7, and 109 (23%) subjects 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% CI, 1.54-5.32; P = .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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