You get a lousy night’s sleep, and then all day long your rescue inhaler becomes your best friend as your chest tightens and you cannot stop coughing. It’s not the first time you’ve woken up groggy after a full night’s rest, and you find yourself wondering if there is a connection between asthma and sleep apnea. Turns out, sleep apnea and asthma do connect in ways that can make your symptoms of both worse. Here’s what you should know.

Are asthma and sleep apnea connected?

Asthma is a respiratory condition characterized by inflamed and narrowed airways. In general, airways become hypersensitive and tell-tale symptoms emerge. These include coughing, wheezing, shortness of breath, and chest tightness.

Sleep apnea is sleep disordered breathing whose hallmark is long pauses in breath while sleeping, followed by a gasping intake of air. Many who suffer from sleep apnea do not wake up during these apneas (pauses in breath), but they do know something’s off when they wake up.

Sleep apnea symptoms include:

  • Daytime fatigue
  • Inability to concentrate
  • Irritability
  • Headache in the morning

Asthma and sleep apnea are connected first in that they are both complications in the respiratory system that compromises breathing. While asthma is increasingly linked to environmental factors (e.g., increasingly poor air quality or indoor allergens), both sleep apnea and asthma also seem to have other connecting risk factors, including:

  • Obesity
  • Systemic inflammation
  • Acid reflux

Even the treatment for asthma can contribute to an increased incidence of people already at risk for sleep apnea.

Corticosteroids in rescue inhalers and other mechanisms designed to keep the airways open can increase your chances of sleep apnea. And on the other hand, sleep disordered breathing also increases nocturnal symptoms of asthma.

What the research says

These asthma and sleep apnea connections have not escaped the notice of researchers. In 2009, studies found that sleep apnea is an independent risk factor for worsening asthma symptoms. This means that even in the absence of indoor pollutants or other risk factors, sleep apnea made asthma symptoms worse.

Other studies and reviews that support the connection between sleep apnea and asthma include the following.

Asthma and sleep apnea create an overlap syndrome

A review of literature in 2014 found that the bidirectional relationship between asthma and sleep apnea worked in such a way as to make symptoms of both worse.

Even mild sleep apnea remodels the airway

Patients with just mild sleep apnea may experience worsening symptoms of asthma as the airway becomes remodeled by sleep disordered breathing.

Asthma increases the risk of new-onset sleep apnea

A 2015 study found that asthma in patients of all ages was connected to a risk of new-onset sleep apnea. The researchers conducting the study found the risk high enough to warrant a recommendation for regular testing for sleep disordered breathing in patients with asthma.

Undiagnosed sleep apnea is related to poor asthma control

Patients who struggle to control their asthma are often suffering from undiagnosed sleep apnea.

These studies (and many more) shed light on the asthma and sleep apnea connection.

Rates of incidence

The U.S. Centers for Disease Control and Prevention place the incidence of asthma in the U.S. at 7.7%, with women more likely to have it than men (9% in women compared to 6.3% in men).

In contrast, sleep apnea is a grossly underdiagnosed syndrome. It affects an estimated 25 million people in the U.S, with 80% of cases going undiagnosed.

It is challenging to estimate how many patients have both conditions, as many patients with obstructive sleep apnea have asthma, and asthma patients often have undiagnosed sleep apnea. Some studies indicate that patients with asthma have a considerably higher risk of developing sleep apnea than the general population, and vice versa.

One meta-analysis of available data found that the incidence of sleep apnea in asthma patients hovered around 50%, with asthma patients having nearly three-times higher risk of developing sleep apnea than non-asthma patients.

How sleep apnea treatments can help with asthma (and vice versa)

So sleep apnea and asthma have a connection. Now what?

The good news is that successful treatment of one condition often corresponds with relief from the other.

One of the biggest risk factors for both conditions is obesity. When it comes to sleep apnea, many people find their symptoms decrease or disappear simply by maintaining a healthy body weight. The same is true for asthma. Excessive fatty deposits in the throat narrow already-narrowed airways, so it makes sense that minimizing those would help with breathing.

Practicing good sleep hygiene, including keeping your bedroom clean and free from pet dander, dust, and other allergens can help control nocturnal asthma. Because sleep apnea alone is associated with bronchial inflammation, it’s important to move any potential triggers from your sleeping area so as to minimize the possibility of both conditions occurring at night.

Further, consider investing in a sleep apnea pillow to slightly elevate your head and keep the airway open. Other sleep apnea pillows keep you on your side, a position that favors an open airway as well.

CPAP machines

One treatment that directly addresses sleep apnea and has a positive treatment outcome for asthma is a continuous positive airway pressure (CPAP) machine. The CPAP machine delivers pressurized air to keep your throat open at night. Other types of PAP machines include the BiPAP (bilevel positive airway pressure) and VPAP (variable positive airway pressure). These supply air on a variable schedule or in a different manner, depending on your needs.

Air is delivered via a mask that fits over either just the nose or the mouth and nose. When used correctly, CPAP machines improve symptoms of both sleep apnea and asthma.

The key to that sentence is “when used correctly.” Because of the noise, bulk, and uncomfortable mask, many sleep apnea patients eventually discontinue use of their CPAP machines, and symptoms worsen.

Fortunately, there are CPAP alternatives to help manage sleep apnea (and lessen asthma symptoms). Sleep apnea dental devices and pillows are easier to use. They may increase compliance with treatment protocols, especially for those with mild cases of sleep apnea.

If you suffer from sleep apnea or asthma, give the sleep apnea dentists at AZ Dentist a call. We can help you sleep well and breathe easy.

Schedule Your Appointment