The effect of Obstructive Sleep Apnoea (OSA) on health outcomes in patients with asthma: epidemiology, impact on asthma control, and effect of treatment using Continuous Positive Airway Pressure (CPAP)

Davies, Sarah Elizabeth (2020). The effect of Obstructive Sleep Apnoea (OSA) on health outcomes in patients with asthma: epidemiology, impact on asthma control, and effect of treatment using Continuous Positive Airway Pressure (CPAP). University of Birmingham. M.D.

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Abstract

Introduction: The aim was to determine the prevalence of OSA in severe asthma (SA), the effect of OSA and the impact of CPAP treatment on asthma-related clinical outcomes.

Methods: Systematic review (SR) of the pre-existing literature, a cross-sectional study, prospective case-control study and a randomised, double-blind, placebo-controlled pilot feasibility study (RCT) were conducted.

Results: SR; 6 studies: 19-60% prevalence in asthma, 50-95% in SA, 13 questionnaire studies; 8-53% prevalence in asthma. Observational studies; 191 participants, 70% prevalence. Asthma-related quality of life, asthma control, depression scores and general quality of life worsened with increasing severity of OSA. SR; CPAP treatment can improve asthma-related quality of life particularly in more severe asthma or severe OSA. RCT; 27 participants recruited, 14 completed study. No change in AQLQ or asthma control with CPAP, but small numbers recruited with high drop-out rate (48%).

Conclusion: A high prevalence of OSA in asthma, and particularly severe asthma exists with negative impact on asthma control and quality of life. Improved asthma-related quality of life with CPAP treatment has been observed, but this was not supported with the RCT. Further research with a large multicentre RCT is needed before firm conclusions can be made on the impact of CPAP treatment.

Type of Work:

Thesis (Doctorates > M.D.)

Award Type:

Doctorates > M.D.

Supervisor(s):