0
Original Research: SLEEP MEDICINE |

Predictors of Habitual Snoring and Obstructive Sleep Apnea Risk in Patients With Asthma

Mihaela Teodorescu, MD, MS; Flavia B. Consens, MD; William F. Bria, MD; Michael J. Coffey, MD; Marc S. McMorris, MD; Kevin J. Weatherwax, BS; John Palmisano, MA; Carolyn M. Senger, BS; Yining Ye, PhD; Jack D. Kalbfleisch, PhD; Ronald D. Chervin, MD, MS
Author and Funding Information

*From the Department of Medicine and Wisconsin Sleep Institute (Dr. Teodorescu), University of Wisconsin, Madison, WI; the Medical Service and Sleep Disorders Center (Dr. Teodorescu), William S. Middleton Veterans Hospital, Madison, WI; the Department of Neurology and Sleep Disorders Center (Drs. Consens and Chervin, Mr. Palmisano, and Ms. Senger) and the Department of Medicine (Drs. Bria and Coffey), University of Michigan Health System, Ann Arbor, MI; the Department of Biostatistics (Drs. McMorris, Ye, and Kalbfleisch), University of Michigan School of Public Health, Ann Arbor, MI; and Michigan Institute for Clinical and Health Research (Mr. Weatherwax), University of Michigan Health System, Ann Arbor, MI.

Correspondence to: Mihaela Teodorescu, MD, MS, 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


This work was performed at the University of Michigan Health System, Ann Arbor, MI.

This research was supported by University of Michigan General Clinical Research Center grant MO1 RR00042 (to M.T.) and University of Michigan Department of Neurology Training Grant T32 NS007222 (to M.T.).

Dr. Teodorescu has received funding from the University of Wisconsin School of Medicine and Public Health, Department of Medicine and from Medical Education and Research Committee New Investigator Award to continue asthma-sleep apnea research. Dr. Coffey has received research funds from the University of Michigan. Dr. Chervin has consulted on the subjects of sleep or sleep apnea for Respironics, Inc, Pavad Medical, Inc, Alexa Pharmaceuticals, Inc, several legal firms, and US District Attorney (each for under $10,000). He is named in a University of Michigan patent on a sleep apnea-related signal analysis algorithm. The other authors have no conflicts of interest to disclose.

For editorial comment see page 1115


© 2009 American College of Chest Physicians


Chest. 2009;135(5):1125-1132. doi:10.1378/chest.08-1273
Text Size: A A A
Published online

Background:  A high prevalence of obstructive sleep apnea (OSA) symptoms was reported in patients with asthma. Our goal was to evaluate factors associated with habitual snoring and OSA risk in these patients.

Methods:  Patients with asthma were surveyed at specialty clinics with the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) and questions about the frequency of asthma symptoms (National Asthma Education and Prevention Program guidelines), followed by medical record review. SA-SDQ scores ≥ 36 for men and ≥ 32 for women defined high OSA risk. Logistic regression was used to model associations with habitual snoring and high OSA risk.

Results:  Among 244 patients, 37% snored habitually and 40% demonstrated high OSA risk. Independent predictors of habitual snoring included gastroesophageal reflux disease (GERD) [odds ratio (OR), 2.19; 95% confidence interval (CI), 1.19 to 4.02] and use of an inhaled corticosteroid (ICS) [OR, 2.66; 95% CI, 1.05 to 6.72]. High OSA risk was predicted by asthma severity step (OR, 1.59; 95% CI, 1.23 to 2.06), GERD (OR, 2.70; 95% CI, 1.51 to 4.83), and ICS use (OR, 4.05; 95% CI, 1.56 to 10.53). Linear, dose-dependent relationships of ICS with habitual snoring and high OSA risk were seen (p = 0.004 and p = 0.0006, respectively). Women demonstrated a 2.11 times greater odds for high OSA risk (95% CI, 1.10 to 4.09) when controlling for the above covariates.

Conclusions:  Symptoms of OSA in patients with asthma are predicted by asthma severity, coexistent GERD, and use of an ICS in a dose-dependent fashion. The well-recognized male gender predominance for OSA symptoms is not apparent in these patients. Further exploration of these relationships may help to explain the increased prevalence of OSA in asthma and provide new insights into the reported female predominance of asthma morbidity.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Snoring in Preschool Children*: Prevalence and Association With Nocturnal Cough and Asthma
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543