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Impact of CPAP on asthmatic patients with obstructive sleep apnoea

¹ Sacre-Coeur Hospital, University of Montreal, Montreal, and ² Pneumology Research Unit, Laval Hospital Research Centre, University Institute of Cardiology and Pneumology, Laval University, Quebec City, QC, Canada.

CORRESPONDENCE: C. Lafond, 5400 Boul. Gouin Ouest, Montreal, QC H4J-1C5, Canada. Fax: 1 5143383699. E-mail: chantal.lafond{at}umontreal.ca

Keywords: Airway responsiveness, asthma, asthma quality of life, continuous positive airway pressure, obstructive sleep apnoea

Received: May 4, 2006
Accepted September 29, 2006

The impact of continuous positive airway pressure (CPAP) treatment on the airway responsiveness of asthmatic subjects with obstructive sleep apnoea (OSA) has scarcely been studied.

A prospective study was performed comparing the changes in airway responsiveness and quality of life in stable asthmatic OSA patients, before and 6 weeks after their nocturnal CPAP treatment.

A total of 20 subjects (11 males and nine females) participated in the study. With the nocturnal CPAP treatment, the apnoea/hypopnoea index dropped from 48.1±23.6·h^-1 to 2.6±2.5·h^-1. There were no significant changes in airway responsiveness after CPAP treatment (provocative concentration causing a 20% fall in forced expiratory volume in one second (FEV₁; PC₂₀ 2.5 mg·mL^-1 (1.4–4.5)) compared with baseline (PC₂₀ 2.2 mg·mL^-1 (1.3–3.5)). There was no significant change in FEV₁ either. However, the asthma quality of life of the subjects improved from 5.0±1.2 at baseline to 5.8±0.9 at the end of the study.

In conclusion, nocturnal continuous positive airway pressure treatment did not alter airway responsiveness or forced expiratory volume in one second in subjects with stable mild-to-moderate asthma and newly diagnosed obstructive sleep apnoea. However, nocturnal continuous positive airway pressure treatment did improve asthma quality of life.