CPAP improves quality of life in asthmatics with coexisting obstructive sleep apnoea

Takeaway

• Continuous positive airway pressure (CPAP) treatment of coexisting obstructive sleep apnoea (OSA) improves asthma-related quality of life.
• This effect appears more pronounced in severe OSA or poorly controlled asthma.

Why this matters

• High prevalence of OSA has been observed in asthma populations, with negative effect on asthma symptoms and control. CPAP is effective for OSA, however, there are reports of patients developing bronchial hyperresponsiveness with CPAP which could affect patients with asthma.

Study design

• 12 studies (8 prospective quasi-experimental and 4 observational studies) met eligibility criteria after a search on EMBASE and MEDLINE databases.
• Funding: None disclosed.

Key results

• Mean duration of CPAP was 19.5 (2-100) weeks.
• Mean asthma quality of life questionnaire (AQLQ) and mini-AQLQ scores improved significantly by 0.59 (95% CI, 0.25-0.92; P=.0006) with CPAP.
• No significant improvement was reported in forced expiratory volume in 1 second % predicted; 0.32 (95% CI, −2.84 to 3.47; P=.84).
• 2 studies used the Asthma Control Test; 1 demonstrated significant improvement while the other did not.
• 1 study used the Asthma Control Questionnaire and demonstrated significant improvement post-CPAP.
• 4 studies improved asthma daytime/nighttime symptoms, and 3 studies demonstrated improved asthma severity.

Limitations

• Small number of studies.
• Presence of heterogeneity.