Asthma Control and Its Relationship with Obstructive Sleep Apnea (OSA) in Older Adults.
Asthma Control and Its Relationship with Obstructive Sleep Apnea (OSA) in Older Adults.
复制标题
哮喘控制及其与老年人的阻塞性睡眠呼吸暂停（OSA）的关系。
DOI：
10.1155/2013/251567
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Teodorescu MC
中科院分区：
文献类型：
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作者：
Teodorescu M;Polomis DA;Gangnon RE;Fedie JE;Consens FB;Chervin RD;Teodorescu MC
背景/目标。老年人的哮喘知之甚少。我们的目的是描述老年哮喘的表型，并检测其与阻塞性睡眠呼吸暂停（OSA）的相关性。设计横截面。设置.肺和哮喘/过敏诊所。参与者659例哮喘受试者，年龄为18-59岁（年轻），154例年龄为60-75岁（老年）。测量.睡眠障碍问卷的睡眠呼吸暂停量表（SA-SDQ）、哮喘严重程度分级（1-4级，如果分级为3或4级，则为重度）、确定的OSA诊断、持续气道正压通气（CPAP）使用和合并症。结果根据哮喘分级、肺功能和吸入性皮质类固醇的使用情况，老年人比年轻人控制得更差。在老年受试者中，在控制已知的哮喘诱发因素后，OSA诊断是与重度哮喘强烈相关的唯一因素：平均而言，OSA与老年个体中重度哮喘的可能性增加近7倍相关（OR = 6.67）。这种关系比年轻受试者更大（OR = 2.16）。使用CPAP使老年受试者严重哮喘的可能性降低了91%（P = 0.005），远高于年轻哮喘患者。结论诊断为OSA增加了老年患者哮喘控制恶化的风险，而CPAP治疗可能对哮喘结局有更大的影响。未被识别的OSA可能是哮喘控制不佳的原因，特别是在老年患者中。
Background/Objectives. Asthma in older individuals is poorly understood. We aimed to characterize the older asthma phenotype and test its association with obstructive sleep apnea (OSA). Design. Cross-sectional. Setting. Pulmonary and Asthma/Allergy clinics. Participants. 659 asthma subjects aged 18–59 years (younger) and 154 aged 60–75 (older). Measurements. Sleep Apnea scale of Sleep Disorders Questionnaire (SA-SDQ), asthma severity step (1–4, severe if step 3 or 4), established OSA diagnosis, continuous positive airway pressure (CPAP) use, and comorbidities. Results. Older versus younger had worse control, as assessed by asthma step, lung function, and inhaled corticosteroid use. Among older subjects, after controlling for known asthma aggravators, OSA diagnosis was the only factor robustly associated with severe asthma: on average, OSA was associated with nearly 7 times greater likelihood of severe asthma in an older individual (OR = 6.67). This relationship was of greater magnitude than in younger subjects (OR = 2.16). CPAP use attenuated the likelihood of severe asthma in older subjects by 91% (P = 0.005), much more than in the younger asthmatics. Conclusion. Diagnosed OSA increases the risk for worse asthma control in older patients, while CPAP therapy may have greater impact on asthma outcomes. Unrecognized OSA may be a reason for poor asthma control, particularly among older patients.