Obstructive Sleep Apnea and Asthma

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Nocturnal asthma can be affected by many contributors including rhinitis, sinusitis, GER, obstructive sleep apnea (OSA), nocturnal allergen exposures (e.g. dust mites, pet dander)

OSA can coexist with asthma and cause worsening of symptoms at night. In addition, OSA can reduce functional residual capacity and lead to pulmonary hypertension which would complicate respiratory disease.

Few case series have described treatment of OSA improving nocturnal and daytime symptoms of asthma. It is unclear why treatment of OSA leads to improvement of lung function & decreased bronchodilator use. Use of CPAP without OSA does not improve nocturnal asthma.

Assessment for sleep disturbance and signs of OSA include abnormal or poor sleep patterns, snoring, gasping, witnessed apnea/ hypopneas / shallow breathing, nocturnal enuresis, morning headaches, excessive somnolence in daytime, and behavioral issues. Referral to Sleep Clinic should be considered.

Further reading: Martin, RJ. Nocturnal Asthma. In: UpToDate, PostTW (ED), UpToDate, Waltham, MA. (Accessed on February 25 2021)