Sleep Apnea Increases Risk of Poor Asthma Control

This is one of the first connections that I pointed out, even before my book was published. So it’s not surprising that still another study links obstructive sleep apnea with poorly controlled asthma. The study authors from University of Wisconsin recommended that all patients with poorly controlled asthma be screened for obstructive sleep apnea. My question is, why not EVERYONE with significant asthma?

Just to review, there are two possible ways obstructive sleep apnea can cause or aggravate asthma. The first is from direct stomach juice exposure. Apneas can suction up your normal stomach juices into your ears, nose, and lungs. Studies have shown pepsin (a digestive enzyme) and H. pylori (a stomach bacteria) in lung washings. All these substances can irritate the lungs.

Another possible mechanism is that frequent arousals causes your nervous system to become heightened, making the nervous system in your lungs overly sensitive to weather changes, chemicals, smoke, irritants and even exercise. This is similar to nonallergic rhinitis, in which your nose is overly sensitive to weather change, chemicals, scents or odors. This is also where the “one-airway, one-disease” concept comes in. Your upper and lower airways are ultimately all connected. Then there are studies that link asthma to reflux, and reflux to nonallergic rhinitis…

Some of my patients have told me that their asthma has improved since treating their sleep apnea. If you have obstructive sleep apnea, do you also have asthma? Please enter your response in the text area below.

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3 thoughts on “Sleep Apnea Increases Risk of Poor Asthma Control

  1. I was diagnosed with severe allergies when I was 4. I’m allergic to house dust, wool, trees and grasses. I live in the San Joaquin Valley in California and I’m allergic to so many trees and grasses that I’m in a constant state of flare. I did allergy shots for ~ 10 years as a kid, but they didn’t help much. My best months are November and January, where only two things are active. However, I also have problems with chemicals and air pollution. I’ve had trouble sleeping since I was little. I don’t recall ever being able to sleep well, or waking up refreshed.

    I’ve also had severe acid reflux for about 10 years. I’ve been taking prilosec daily since 20002 and it isn’t always enough. I still frequently have acid coming up in my throat and sometimes even my mouth, especially if I’m bending over a lot (gardening, washing floors etc).

    I started having trouble breathing during the day about a year and a half ago and last winter it was getting pretty severe. I was diagnosed with asthma. I’m currently on 250/50 advair, singulair, pseudoephedrine and carry proair with me. My asthma still isn’t under control so I’m seeing a new allergist on the 20th for help.

    I’m 40 now. The last few years I started having severe migraines that would last 7 – 10 days and a cocktail of 200 mgs imitrex + aleve + motrin + vicodin barely made them tolerable so that I could work. I went to a neurologist at Stanford, who sent me for a sleep study where I was diagnosed with moderate- severe sleep apnea. I wake up 40x/hour. I spend almost the entire night in stage 2 sleep. I only went into REM twice for a total of about 20 minutes. At the time, I was barely functional. I could barely focus or concentrate and it was really interfering with my ability to work. I was managing a stem cell research lab at a University and work with a lot of toxic chemicals and acids. I was having problems just reading a scientific paper. I’d have to re-read a paragraph several times to get the gist of it, then had difficulty retaining it. Our lab was a teaching lab, so I was supposed to supervise and teach students, so this was a big problem. I tried using a CPAP last fall for ~ 4 months but couldn’t get used to it. It made my lungs hurt and my asthma worse. But again, I live in the central valley where air quality is really bad year-round. I finally resigned from my position in June. Since I gave up on the CPAP, I am taking ambien daily now which helps me get more deeper sleep. Not the best solution, but I am getting more sleep now and feeling a little better. I need to get the asthma under control though.

  2. wow Tanya, you need to do something for your sleep apnea. I failed CPAP also, kept taking it off. but I am doing OK with a tongue retaining device called the aveoTSD; ask your doc to order you one. it takes a few weeks to get used to it but it’s more comfortable than CPAP for me; I think the blowing was waking me up. and I am finally getting better after severe fatigue set in just over a year ago. I have had inspiratory chest pain on and off and especially at night for about 21 months now, although I am getting better now on Flovent and the aveoTSD. I am not sure if the pain is from acid in my lungs or from the asthma. it started during a bad cold in January 09 and a few weeks later I developed rapidly progressive shortness of breath that was diagnosed as asthma. the cold started instantly after a Lysol spray exposure and since I am chemically sensitive I assumed that the Lysol triggered my asthma. now I have a new theory; the cold made my UARS act up and the acid triggered the asthma. in August of 09 is when the severe fatigue set in, and I only discovered the UARS about 2 months ago.

  3. I have severe allergies, allergic asthma, and sleep apnea. Living in South Georgia is a probably because it is always something blooming here, but some months are worst than others. I have started on a CPAP and have learned to tolerate it, but only when I am not having allergy flare-ups. When my allergies flare-up, I usually have trouble sleeping because when I lay down I start coughing incessantly throughout the night, awaking several times. When I start coughing, the CPAP has to come off. I am tired quite a bit. It usually takes a long time before I can just drift off to sleep. Sleeping pills are out of the question.