title: Association of obstructive sleep apnea risk or diagnosis with daytime asthma in adults.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) worsens nocturnal asthma, but its potential impact on daytime asthma remains largely unassessed. We investigated whether the sleep disorder is associated with daytime, in addition to nighttime, asthma symptoms.
  
  
  METHODS
  Asthma patients at tertiary-care centers completed the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ), and an asthma control questionnaire. SA-SDQ scores ≥36 for males and ≥32 for females defined high OSA risk. Medical records were reviewed for established diagnosis of OSA and continuous positive airway pressure (CPAP) use.
  
  
  RESULTS
  Among 752 asthma patients, high OSA risk was associated similarly with persistent daytime and nighttime asthma symptoms (p < .0001 for each). A diagnosis of OSA was robustly associated with persistent daytime (p < .0001) in addition to nighttime (p = .0008) asthma symptoms. In regression models that included obesity and other known asthma aggravators, high OSA risk retained associations with persistent daytime (odds ratio [OR] = 1.96 [95% confidence interval [CI] = 1.31-2.94]) and nighttime (1.97 [1.32-2.94]) asthma symptoms. Diagnosed OSA retained an association with persistent daytime (2.08 [1.13-3.82]) but not with nighttime (1.48 [0.82-2.69]) asthma symptoms. CPAP use was associated with lower likelihood of persistent daytime symptoms (0.46 [0.23-0.94]).
  
  
  CONCLUSIONS
  Questionnaire-defined OSA risk and historical diagnosis were each associated with persistent daytime asthma symptoms, to an extent that matched or exceeded associations with nighttime asthma symptoms. Unrecognized OSA may be a reason for persistent asthma symptoms during the day as well as the night.
authors: Section of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Madison, WI 53792, USA. mt3@medicine.wisc.edu
authors: Mihaela
authors: M
authors: Teodorescu
authors: David A
authors: DA
authors: Polomis
authors: Mihai C
authors: MC
authors: Teodorescu
authors: Ronald E
authors: RE
authors: Gangnon
authors: Andrea G
authors: AG
authors: Peterson
authors: Flavia B
authors: FB
authors: Consens
authors: Ronald D
authors: RD
authors: Chervin
authors: Nizar N
authors: NN
authors: Jarjour
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires