The effect of CPAP in asthma patients with SAHS

Introduction: Sleep apnea-hypopnea syndrome (SAHS) is an important risk factor for poor asthma control. The objective of this study is to analyze the symptomatic control in asthmatic patients with SAHS after using CPAP. Methods: Patients were collected in a monographic asthma consult and a polygraphy was performed due to clinical suspicion or poor disease control. Asthma associated pathologies, as well as clinical and patient-perceived asthma control parameters were evaluated before and after the initiation of CPAP. Results: 100 patients were included, 59% were women and 41% men, with a mean age of 67 ± 13 years and a BMI of 32 ± 6.6 kg / m2. 50% had never smoked and 43% were ex-smokers. 94% had inhaled corticosteroid, 41% at high and 27% at medium doses. 89% had LABA while 20% had LAMA; 22% associate SABA and 5% SAMA. In addition, 2% had received oral corticosteroids, 2% biological treatment (before CPAP treatment), 28% antileukotrienes and 38% intranasal corticosteroids. 54% had severe SAHS, 33% moderate and 13% mild. 10% could not tolerate CPAP. 84% had a moderate or severe degree of asthma with an ACT before CPAP of 19 ± 4.6 and FENO 32 ± 24.6. Asthma control before CPAP was good in 41% of patients, partial in 29%, and bad in 30%. After 3 or more months of CPAP, clinical asthma control was good in 70% (p <0.001), perceived control by ACT test after CPAP was 21 ± 4 (p <0.001). 51.5% referred clinical improvement after CPAP, no change in 46.5%. Conclusions: The use of CPAP in asthmatic patients with SAHS improves both clinical and perceived asthma control in a statistically significant way. Most patients have good adaptation to CPAP (90%) and 51.5% have clinical improvement.