You might be surprised to learn that nearly half of all asthmatics have sleep apnoea, compared to just 3% of the general population! It’s of no wonder really — they both share common risk factors such as inflamed airways and being overweight.
If controlling your asthma wasn’t already hard enough, having untreated sleep apnoea makes it almost impossible. But don’t be disheartened; new research has found that CPAP therapy will not only prevent apnoeas but can also help improve your asthma.
Researchers recently followed a group of 99 people with both conditions and found that using CPAP for at least six months benefited asthma in the following remarkable ways:
1. Improves asthma control
If your asthma is not well controlled your preventative inhalers are no longer adequate and you begin to rely heavily on your relievers.
The research suggests treating sleep apnoea with CPAP can help keep your asthma under control. The percentage of asthmatic patients with poorly controlled asthma declined from 41.4% to 17.2% after CPAP use.
2. Reduces your chance of having an asthma attack
There are few things more frightening than not being able to breathe during an asthma attack. Many people having an attack end up visiting their local A&E department for nebulisers and oxygen therapy.
CPAP can help reduce the number of asthma attacks you experience. The study found the percentage of people having attacks declined from 35.4% to 17.2% after CPAP treatment.
3. Reduces your chance of having an exacerbation
If your asthma suddenly gets much worse you are having what is known as an ‘exacerbation’. They are usually triggered by respiratory tract infections that destabilise your condition. They are typically treated with antibiotics and prednisolone, a steroid-based pill. Severe exacerbations can sometimes result in a stay in hospital.
CPAP can help to reduce your chances of having an exacerbation. The percentage of patients who had an exacerbation in the 6 month period before CPAP treatment was 35.4%. In the 6 month period after CPAP started, this declined to 17.2%.
4. Reduces acid reflux disease
Acid reflux occurs when stomach acid enters the food pipe and damages its delicate lining. Acidic gases can also rise up and reach the throat and airways, causing irritation and cough. Needless to say, this can make your asthma much worse. Sleep apnoea is notorious for causing acid reflux – each time you have an apnoea your stomach is squeezed which can force acid into your food pipe.
The research suggests that CPAP can prevent acid reflux in many people. The percentage of asthmatics with acid reflux disease declined from 30.3% to 10.1% after CPAP use.
5. Reduces rhinitis
If you have allergic rhinitis, your nasal passages become inflamed when you breathe in pollen, dusts or animal dander. If you are asthmatic you are more likely to suffer from rhinitis as they share similar triggers.
CPAP seems to reduce the symptoms of allergic rhinitis in asthmatics. The percentage of people with mild rhinitis declined from 35.4% to 22.2% after using CPAP.
6. Reduces airway inflammation
Nitric oxide is a chemical produced by the airways when they are inflamed — for example when your asthma is playing up. The amount of nitric oxide in your breath indicates the severity level of the inflammation — the higher the level, the more inflamed the airways.
Asthma medication aims to reduce the level of airway inflammation and we can tell it’s working when the level of nitric oxide in your breath declines.
Just like asthma medication, CPAP reduces the amount of inflammation in your airways causing a decline in nitric oxide levels. The research showed the level of nitric oxide declined from 29.9 parts per billion to 22.0 parts per billion, on average, after using CPAP. This means those asthmatics with an ‘intermediate’ level of nitric oxide in their breath, had a ‘low’ level after using CPAP.
7. Reduces daytime sleepiness
Asthma and sleep apnoea both cause daytime sleepiness. Asthma causes symptoms such as wheezing and coughing that can keep you awake at night while apnoeas repeatedly disrupt your sleep. Both leave you feeling sleepy the following day. Having one condition alone is bad enough, but when they are combined, it’s likely you’ll reach a permanent state of exhaustion.
Daytime sleepiness can be estimated using a questionnaire called the Epworth Sleepiness Scale (ESS). A score of 10 or above is abnormal, suggesting you are sleepier than you should be. The study shows CPAP can help reduce your ESS. The percentage of asthmatics with an Epworth score above 11 declined from 59.6% to 13.1% after 6 months of CPAP.
8. Improves your asthma-related quality of life
If you have sleep apnoea and poorly controlled asthma, CPAP is likely to improve your asthma-related quality of life. The research discovered that 53.7% of participants with poorly controlled asthma reported an improvement in their quality of life after using CPAP.
Do you have asthma and sleep apnoea? Have your symptoms improved with treatment or are you still struggling to control your asthma? We would love to hear your story in the comments section below.
Just been told I have OSA and I’ve already got pretty bad asthma. I’ve been avoiding getting my CPAP because reasons*, but might have to reconsider. I’ll pop back in here and let you know if I see any improvements.