Open AccessCLINICAL AND FUNCTIONAL PECULIARITIES OF COMORBID OBSTRUCTIVE SLEEP APNEA SYNDROME AND ASTHMA
Author(s) -
Elizaveta Sheludko,
Elizaveta Sheludko,
Денис Наумов,
Денис Наумов,
Anna Prikhodko,
Anna Prikhodko,
Виктор Колосов,
Виктор Колосов
Publication year - 2019
Publication title -
bûlletenʹ fiziologii i patologii dyhaniâ
Language(s) - English
Resource type - Journals
ISSN - 1998-5029
DOI - 10.12737/article_5c88b5e86b9c18.75963991
Subject(s) - medicine , asthma , spirometry , obstructive sleep apnea , comorbidity , cardiology , concomitant , diabetes mellitus , cardiorespiratory fitness , epworth sleepiness scale , physical therapy , polysomnography , apnea , endocrinology
Obstructive sleep apnea syndrome (OSAS) is a pathogenetically heterogeneous condition that aggravates the course of asthma. For this reason, timely diagnosis and treatment of OSAS may improve asthma control, reduce the number of exacerbations and the frequency of short-acting bronchodilators use. The aim of the study was to describe the clinical and functional features of patients with asthma and OSAS, and to identify risk factors that allow suspecting the comorbidity. A total of 194 patients with asthma were examined. The research methods included assessment of symptoms using the ACT questionnaire, spirometry with bronchoprovocational tests, body plethysmography and determination of lung diffusion capacity, analysis of the cellular composition of induced sputum, echocardiography, overnight cardiorespiratory monitoring. According to the results of cardio-respiratory monitoring OSAS of varying severity was detected in 33% of patients (n=65). Epworth sleepiness scale did not allow specific discrimination of OSAS among the examined patients. In general, patients with the comorbid pathologies were more often men of older age groups, they had a long history of disease and smoking. In patients with OSAS diabetes and cardiovascular diseases were more common in the structure of concomitant pathology. The presence of OSAS did not significantly affect spirometry but was associated with a pronounced airway hyperresponsiveness regardless of the provocative stimulus. In addition, a higher airway resistance and an increase in lung diffusion capacity were noted in OSAS patients. Neutrophilic phenotype of inflammation was three times more common in case of concomitant OSAS, and signs of cardiac remodeling and an increase in pulmonary artery pressure were also observed in these patients. Thus, knowledge of the above features of asthma-OSAS phenotype will facilitate timely diagnosis and optimal therapeutic care for patients with a combination of pathologies.