Obstructive sleep apnea (OSA) occurs more commonly in asthma patients than in the general population because these conditions share some comorbidities. In Japan, the prevalence of OSA in the general population is reported to be approximately 20%; however, few reports have described the prevalence of OSA in asthma patients. Furthermore, the characteristics of Japanese patients with OSA and asthma are not clear. Adult asthma patients were recruited from the outpatient departments of our institution between August 31, 2017, and March 31, 2019. In all included patients, the presence and severity of OSA were evaluated by the Epworth Sleepiness Scale (ESS) and a home sleep test (HST) using portable polysomnography (PSG). The rate of coexisting OSA in asthma patients and the characteristics of those patients according to the severity of OSA were investigated. Fifty-three patients were included. OSA was detected in 36 (67.9%) patients (mild, n = 15; moderate, n = 14; and severe, n = 7). Patients with OSA had significantly higher body mass index, Brinkman index, apnea-hypopnea index (AHI), and 3% oxygen desaturation index (ODI) values in comparison to those without OSA, while the percentage of the predicted value of forced vital capacity (%FVC) and lowest SpO2 levels were significantly lower. As the severity of OSA increased, age, brain natriuretic peptide level, AHI, and 3%ODI increased, and in contrast, FVC, %FVC, forced expiratory volume in one second (FEV1), percentage of the predicted value of FEV1 (%FEV1), Epworth Sleepiness Scale (ESS), 3%ODI, and lowest SpO2 levels decreased. In particular, the fact that the ESS value was inversely correlated with the severity of OSA in our patients was different from the general characteristics of OSA. Moreover, the AHI value was negatively correlated with FVC, %FVC, FEV1, and %FEV1. BMI was the only independent factor for the presence of OSA, and for asthma severity (FEV1, % of predicted), there was a weak correlation with smoking history. This is the first report to investigate the prevalence of OSA in Japanese asthma patients, using an HST. This study suggests that an HST should be performed in addition to the sleep interview for asthma patients with refractory disease, a low pulmonary function, advanced age, and high BMI because the more severe the OSA, the lower the ESS value may be.

中文翻译：

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日本哮喘患者阻塞性睡眠呼吸暂停的患病率

阻塞性睡眠呼吸暂停 (OSA) 在哮喘患者中比在普通人群中更常见，因为这些疾病都有一些合并症。据报道，日本普通人群中 OSA 的患病率约为 20%；然而，很少有报告描述哮喘患者 OSA 的患病率。此外，日本 OSA 和哮喘患者的特征尚不清楚。 2017年8月31日至2019年3月31日期间从我们机构的门诊部招募成年哮喘患者。在所有纳入的患者中，通过Epworth嗜睡量表（ESS）和家庭睡眠测试评估OSA的存在和严重程度(HST) 使用便携式多导睡眠图 (PSG)。对哮喘患者中同时存在 OSA 的比例以及根据 OSA 严重程度的患者特征进行了调查。其中包括 53 名患者。 36 名 (67.9%) 患者检测到 OSA（轻度，n = 15；中度，n = 14；重度，n = 7）。与无 OSA 的患者相比，OSA 患者的体重指数、Brinkman 指数、呼吸暂停低通气指数 (AHI) 和 3% 氧饱和度指数 (ODI) 值显着升高，而用力肺活量预测值的百分比 ( %FVC）和最低 SpO2 水平显着降低。随着OSA严重程度的增加，年龄、脑钠肽水平、AHI和3%ODI增加，相反，FVC、%FVC、一秒用力呼气量（FEV1）、FEV1预测值的百分比（% FEV1)、Epworth 嗜睡量表 (ESS)、3%ODI 和最低 SpO2 水平下降。特别是，我们患者的 ESS 值与 OSA 严重程度呈负相关，这与 OSA 的一般特征不同。此外，AHI值与FVC、%FVC、FEV1和%FEV1呈负相关。 BMI 是 OSA 存在的唯一独立因素，而哮喘严重程度（FEV1，预测百分比）与吸烟史的相关性较弱。这是第一份使用 HST 调查日本哮喘患者 OSA 患病率的报告。本研究建议，对于患有难治性疾病、肺功能低下、高龄和高BMI的哮喘患者，除了睡眠访谈外还应进行HST，因为OSA越严重，ESS值可能越低。