How Are Asthma and Sleep Apnea Related?

Asthma and sleep apnea are similar in many ways. Both disorders affect the respiratory system. They can be managed with certain lifestyle changes and treatment, but not cured, which means you need to learn to live with them in the long term. 

Moreover, both conditions can have a serious negative impact on health and even be fatal if not managed. Overlooking either disease can pose risks to your health, so being informed is crucial. In this article, we explore the relationship between asthma and sleep apnea.

What’s asthma?

This condition causes the airways that go down to the lungs to become swollen. Airway passages become too narrow due to inflammation, which makes it difficult to breathe, as not enough air can flow through. 

Symptoms include:

  •  Shortness of breath, even when you’re not doing any physical activity.
  •  A tight feeling in the chest (as if you couldn’t draw enough air).
  • Chest pain.
  • Wheezing.
  • Coughing.

Common asthma triggers and risk factors include allergies, exposure to pollution, and infections that affect the airways, like sinusitis.

These asthma symptoms can cause sleep disturbances too. In fact, asthma patients often report poor quality sleep, daytime fatigue, and waking up feeling tired. 

What’s sleep apnea?

Although sleep apnea also causes breathing problems, the reason why they happen is different from what happens during an asthma attack.

In people with sleep apnea, breathing interruptions happen while the person is asleep. Usually, they are caused by a blockage in the upper airways, such as the tongue collapsing back into the throat. 

Sometimes, the blockage is caused by excess fatty tissue in the neck and throat area, which interrupts the normal flow of oxygen when a person lays down.

Breathing interruptions caused by sleep apnea can happen multiple times every night, but unlike it happens with asthma, the person isn’t aware of the problem. 

Also unlike asthma, which typically develops during childhood, sleep apnea is more prevalent in adults, and especially in those over the age of 50.

Some of the most common symptoms include:

  •  Loud snoring.
  •  Breathing pauses during sleep, followed by gasping or choking noises.
  • Daytime fatigue and excessive sleepiness.
  • Frequent morning headaches.
  • Waking up feeling tired.
  • Changes to memory or concentration ability.
  • Mood swings, irritability.

As you can see, some sleep apnea symptoms overlap with those of asthma, mainly in that they both cause sleep disruptions. However, the link between these two conditions goes beyond the similarity in some of their symptoms.

How are asthma and sleep apnea related?

Medical research suggests that people with asthma are more likely to develop sleep apnea. A study showed that the number of asthmatic patients who developed OSA (the most common form of sleep apnea) over the course of 4 years was nearly 30%, compared to a 16% chance in people who didn’t have asthma. 

Although researchers don’t exactly know why or how this happens, the general hypothesis is that inflammation and poor muscle tone in the airways of asthmatic patients may trigger OSA symptoms. 

Another theory is that over time, the use of corticosteroids (which are often prescribed to alleviate inflammation in asthma patients) can cause excess fatty tissue in the upper airways, eventually causing blockages and leading to the development of sleep apnea. 

On the other hand, studies have also found that obstructive sleep apnea can make asthma symptoms worsen, and in many cases it increases the frequency of nighttime asthma symptoms.

This doesn’t mean that one disorder always causes the other, but if you suffer from either sleep apnea or asthma, you need to be extra vigilant about the possibility of developing the other condition. This is particularly important if any of the following shared risk factors apply to you:

  •  Being overweight or obese, since extra weight is a risk factor for both sleep apnea and asthma. For example, obese and overweight patients account for 75% of all asthma-related emergency room visits. In addition, approximately 70% of sleep apnea patients are obese.
  •  Acid reflux, which is common in people affected by both conditions.
  • Allergic rhinitis, which can make asthma symptoms hard to control and which increases the risk of developing obstructive sleep apnea.
  • Genetic factors, such as having a family history of respiratory diseases (including asthma) or relatives who also struggle with sleep apnea.

Managing sleep apnea and asthma

While neither asthma nor sleep apnea can be completely cured (although some children outgrow their symptoms), these disorders can be managed and the right treatment can improve your quality of life. 

Traditionally, asthma is managed with inhalers, nebulizers, and with medication that alleviate inflammation. 

On the other hand, sleep apnea treatment involves nightly CPAP therapy. CPAP machines deliver a constant stream of pressurized air into the airways, so they stay open through the night. Although CPAP is not an asthma treatment, some people with both conditions have seen an improvement to their asthma symptoms after starting CPAP therapy. The results are more obvious in people with severe sleep apnea or with hard-to-control asthma.

Final Thoughts

If sleep disruption is interfering with your health, speak to your doctor to get an accurate diagnosis. If you already have been diagnosed with asthma or sleep apnea, being consistent with the prescribed treatment and making the necessary lifestyle changes can help improve your quality of life.