Background:

Previous studies have shown that there is a double-association between obstructive sleep apnea (OSA) and asthma, although the exact pathophysiological mechanism is yet unclear. The prevalence of OSA and its risk factors in patients with severe asthma under treatment with monoclonal antibodies (?biologics?) has not been assessed yet.

Aims and objectives:

This study aims to quantify the prevalence of OSA in patients with severe asthma on current treatment with biologics and to determine their risk factors and related comorbidities.  

Methods:

A retrospective cross-sectional study was performed. All patients with severe asthma who were treated in 2022 with biologics at the Cantonal Hospital of the Grisons (KSGR) in Chur, Switzerland were reviewed. Of these patients, we then included the ones concomitantly suffering from OSA, which had been diagnosed by polysomnography or polygraphy following national standards and reviewed various parameters. 

Results:

A total number of 71 patients with severe asthma were treated in 2022 with biologics at KSGR. Of those, 28 (39,4%) were concomitantly suffering from OSA, 18 were males and 10 females. Their median age was 62 years, their median BMI was 30 km/m2, their median neck-circumference 44cm in males and 38cm in females. The most common comorbidity was chronic hypertrophic polypoid rhinosinusitis, which was found in 79% of them. The median AHI at diagnosis was 24/h; 54% of them were successfully treated with CPAP, 21% with sleep position training, 25% could not tolerate CPAP.

Conclusions:

A high prevalence of OSA was found in patients with severe asthma under treatment with biologics. Risk factors included male sex and chronic rhinosinusitis.