From the Research
Yes, a sleep study is justified for a patient with bronchial asthma who complains of unrefreshing sleep. This is particularly important because there is a significant bidirectional relationship between asthma and sleep disorders, especially obstructive sleep apnea (OSA), as highlighted in a recent study 1. Patients with asthma have a higher prevalence of sleep-disordered breathing, and poor sleep quality can worsen asthma control. The sleep study (polysomnography) can identify conditions like OSA, which may coexist with asthma in up to 46% of patients, as shown in a study published in 2018 2, and can exacerbate asthma symptoms through shared inflammatory pathways.
Key Considerations
- The prevalence of OSA in asthma patients is significant, with 46% of patients having OSA, and 20% having severe OSA 2.
- Sleep disturbances are common in asthmatic patients, with 93% of patients experiencing sleep disturbances, including daytime sleepiness and tiredness, difficulty in maintaining sleep, and early morning awakening 3.
- Treatment of identified sleep disorders can significantly improve both sleep quality and asthma control, with CPAP therapy for OSA in asthmatic patients shown to reduce asthma exacerbations and improve overall respiratory function 1.
- Early identification and management of sleep disorders in asthmatic patients can break the cycle of poor sleep and worsening asthma control.
Recommendations
- A sleep study should be considered for patients with bronchial asthma who complain of unrefreshing sleep, especially if they have risk factors for OSA, such as obesity, smoking, or a history of snoring.
- The sleep study results may guide adjustments to the patient's asthma medication regimen, potentially including timing adjustments of inhaled corticosteroids or long-acting bronchodilators to better control nighttime symptoms.
- Treatment of sleep disorders, such as OSA, can improve asthma control and quality of life, as shown in a study published in 2018 1.