Asthma and Obstructive Sleep Apnea

According to research conducted by the National Institute of Health (NIH), mounting evidence implicates OSAS as a risk factor for asthma exacerbations, thereby linking these 2 major epidemics.

OBJECTIVE: To review the concept of a possible link between asthma and obstructive sleep apnea syndrome (OSAS) and the impact on asthma symptoms of treatment of OSAS with continuous positive airway pressure (CPAP) in patients with both conditions. DATA SOURCES: The Ovid, MEDLINE, and PubMed databases from 1950 to the present were searched for relevant articles regarding a possible relationship between asthma and OSAS and the effectiveness of CPAP in treating OSAS. STUDY

SELECTION: Articles describing pathophysiologic conditions occurring in OSAS that may be linked to asthma pathogenesis were used for this review. RESULTS: The data suggest that OSAS is an independent risk factor for asthma exacerbations. CPAP has been shown in prospective clinical studies to have a positive impact on asthma outcome in patients with concomitant OSAS. Ameliorative mechanisms of treatment with CPAP include mechanical and neuromechanical effects, gastroesophageal acid reflux suppression, local and systemic anti-inflammatory effects (including suppression of increased serum levels of inflammatory cytokines, chemokines, and vascular endothelial growth factor), cardiac function improvements, leptin level suppression, weight reduction, and sleep restoration.

CONCLUSIONS: Asthma and OSAS are increasingly troublesome public health issues. Mounting evidence implicates OSAS as a risk factor for asthma exacerbations, thereby linking these 2 major epidemics. We describe potential mechanisms whereby CPAP, the first line of therapy for OSAS, might modify airway smooth muscle function and asthma control in patients with both disorders. Despite the ever-increasing population of patients with both disorders, large, prospective, randomized controlled studies are necessary to more fully evaluate CPAP and asthma outcomes.

PLEASE NOTE: The information provided above is offered to you as a public service and not intended to replace your relationship with your physician. Please seek medical attention with any and all of your questions regarding your health.

Asthma and Flu Study Announced

Boston.com is reporting that researchers from Boston University are embarking on a national study of women who take medications or get vaccinated while they are pregnant, starting with flu and asthma treatments because they are widely taken and a common cause of concern.

BU’s Slone Epidemiology Center will compare women whose babies have major birth defects to mothers of normal babies, assessing their exposure to asthma medications, seasonal and H1N1 vaccine, and antiviral drugs such as Tamiflu. Based on information obtained from hospitals and birth registries, the researchers will interview mothers by telephone in Massachusetts, Philadelphia, San Diego, and New York state.

In another arm of the study, the Organization of Teratology Information Specialists will enroll pregnant women who use these medications or vaccines and compare them to pregnant women who don’t, following both groups after the babies are born.

“Our hope is to offer reassurance that a previously neglected area is going to receive some attention,” Slone director Dr. Allen Mitchell said in an interview.

Asthma drugs are the most commonly prescribed medications for pregnant women, he said, and health officials have noted pregnant women’s concerns about flu vaccine and medications.

“It’s not as though there’s good evidence that any of these agents are causing major problems,” Mitchell said. “Rather, there isn’t much data in the first place and some of the little data there are, are conflicting. Our hope is a large, rigorous study will be able to provide some credible answers.”

The study is funded by two federal bodies. The Agency for Healthcare Research and Quality is giving $2.5 million over five years and the Biomedical Advanced Research and Development Authority is spending $7.5 million for two years. Both grants are renewable. The effort, called the Vaccines and Medications in Pregnancy Surveillance System, or VAMPSS, is coordinated by the American Academy of Allergy, Asthma, and Immunology.

While the initial focus will be on flu and asthma, the surveillance system could be adapted to study other products pregnant women take in order to fill gaps in medical evidence, Mitchell said. “Postmarketing studies of drugs in pregnancy have been extremely haphazard.”

The true cost of Asthma