Predictive factors for obstructive sleep apnea in adults with severe asthma receiving biologics: a single-center cross-sectional study,Sleep and Breathing

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Predictive factors for obstructive sleep apnea in adults with severe asthma receiving biologics: a single-center cross-sectional study
Sleep and Breathing ( IF 2.1 ) Pub Date : 2022-09-24 , DOI: 10.1007/s11325-022-02710-2
Ana M S Araujo ₁ , Ricardo L M Duarte ₁ , David Gozal ₂ , Alexandre P Cardoso ₁ , Fernanda C Q Mello ₁

Affiliation

Purpose

To evaluate the prevalence and potential predictors of obstructive sleep apnea (OSA) in a cohort of adults with severe asthma.

Methods

From March 2021 to December 2021, this cross-sectional study enrolled patients with severe asthma receiving biologics, who were consecutively referred for sleep evaluation irrespective of sleep-related symptoms. Clinical and functional data, including three OSA screening instruments (GOAL, STOP-Bang, and NoSAS) were recorded. All participants underwent a portable sleep test (ApneaLink Air™). OSA diagnosis was based on the respiratory disturbance index ≥ 5.0/h and subclassified according to severity thresholds. Data were subjected to logistic regression tests to identify possible predictors for OSA. Discrimination was estimated from the area under the curve (AUC).

Results

Overall, 56 outpatients were included (80% females): 54% with any OSA, 13% with moderate-to-severe OSA, and 4% with severe OSA. In the multivariate analysis, no parameter emerged as an independent predictor for OSA: age (p = 0.080), body mass index (p = 0.060), loud snoring (p = 0.130), and hypertension (p = 0.848). No screening instrument was useful to predict any OSA: GOAL (AUC: 0.714; 95% confidence interval (CI): 0.579–0.849), NoSAS (AUC: 0.645; 95% CI: 0.497–0.793), and STOP-Bang (AUC: 0.640; 95% CI: 0.493–0.788). Similarly, no screening tool was also useful for predicting moderate-to-severe OSA or severe OSA.

Conclusion

Patients with evere asthma receiving biologics exhibit a high prevalence of OSA. However, no clinical, functional, or OSA screening instrument showed acceptable discriminatory ability to predict the presence of OSA in these patients with severe asthma.

中文翻译：

接受生物制剂治疗的重度哮喘成人阻塞性睡眠呼吸暂停的预测因素：一项单中心横断面研究

目的

评估一组患有严重哮喘的成人阻塞性睡眠呼吸暂停 (OSA) 的患病率和潜在预测因子。

方法

从 2021 年 3 月到 2021 年 12 月，这项横断面研究招募了接受生物制剂治疗的严重哮喘患者，无论睡眠相关症状如何，这些患者都被连续转诊进行睡眠评估。记录了临床和功能数据，包括三种 OSA 筛查工具（GOAL、STOP-Bang 和 NoSAS）。所有参与者都接受了便携式睡眠测试 (ApneaLink Air™)。OSA 诊断基于呼吸障碍指数 ≥ 5.0/h，并根据严重程度阈值进行细分。对数据进行逻辑回归测试以确定 OSA 的可能预测因子。从曲线下面积 (AUC) 估计歧视。

结果

总体而言，包括 56 名门诊患者（80% 为女性）：54% 患有任何 OSA，13% 患有中度至重度 OSA，4% 患有重度 OSA。在多变量分析中，没有参数成为 OSA 的独立预测因子：年龄 ( p = 0.080)、体重指数 ( p = 0.060)、大声打鼾 ( p = 0.130) 和高血压 ( p = 0.848)。没有筛查工具可用于预测任何 OSA：GOAL（AUC：0.714；95% 置信区间 (CI)：0.579–0.849）、NoSAS（AUC：0.645；95% CI：0.497–0.793）和 STOP-Bang（AUC ：0.640；95% CI：0.493–0.788）。同样，没有筛查工具也可用于预测中度至重度 OSA 或重度 OSA。