Steroid use predicts sleep problem in asthmatics

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People with asthma who use steroid inhalers are at increased risk for obstructive sleep apnea, new research shows.

Obstructive sleep apnea is a common problem in which tissues in the back of the throat collapse during sleep causing temporary blockages and interruptions in breathing. Snoring and daytime sleepiness are common symptoms and the disorder can be effectively treated with a device that provides a puff of air to the back of the throat during sleep.

Other predictors of sleep apnea in asthmatic patients include more severe asthma and gastroesophageal reflux disease, a common heartburn-causing problem, according to the report in the journal Chest. 

"These findings offer some guidance as to which asthma patients may benefit from screening for obstructive sleep apnea, a condition which in turn may worsen asthma control,” lead author Dr. Mihaela Teodorescu, of the University of Wisconsin, Madison, told Reuters Health. “They also raise the intriguing possibility that steroid treatment may induce changes in the upper airway that could lead to development or aggravate obstructive sleep apnea.”

Teodorescu and colleagues surveyed patients with asthma using the Sleep Apnea scale of the Sleep Disorders Questionnaire. They also reviewed medical records.

Of 244 patients included in the study, 90 snored habitually.

Gastroesophageal reflux disease and steroid inhaler use both increased the risk of obstructive sleep apnea by more than twofold. Moreover, as asthma severity increased, so did the risk of sleep apnea.

“Inhaled...steroids are the most effective medications for asthma treatment,” Teodorescu said. “Their use, if needed, should not be discouraged by these findings. However, further research is necessary to understand their upper airway effects during sleep.”

SOURCE: Chest, May 2009.

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