Obstructive sleep apnea, sinusitis, and gastroesophageal reflux disease associated with severe asthma exacerbations

According to research performed at Saint Louis University, St. Louis, Missouri, obstructive sleep apnea (OSA), sinusitis, and gastroesophageal reflux disease (GERD) are associated with severe asthma exacerbations.

The investigators performed a retrospective, cross-sectional analysis of medical claims made from January 2006 to December 2008. The study included 145,950 asthmatics, 73.99% of whom used at least one form of asthma controller therapy. The prevalence of OSA, sinusitis, and GERD was 7.44%, 16.98%, and 17.04%, respectively. Asthma-related hospitalizations were associated with a diagnosis of OSA (ARR 51.71; confidence interval [CI], 1.53 to 1.91), sinusitis (ARR 1.48; CI, 1.36 to 1.61), and GERD (ARR 1.62; CI, 1.50 to 1.76). 

Asthma-related ED visits were associated with a diagnosis of OSA (ARR 1.91; CI, 1.40 to 2.54), sinusitis (ARR 1.35; CI, 1.07 to 1.71), and GERD (ARR 1.66; CI, 1.33 to 2.07). Finally, an increased rate of oral steroid bursts was found in patients with OSA (ARR 1.14; CI, 1.11 to 1.17), sinusitis (ARR 1.73; CI, 1.70 to 1.76), and GERD (ARR 1.13; CI, 1.11 to 1.15).