Treatment With CPAP for Asthma

If sleep apnea makes asthma worse, does treatment with CPAP make asthma better?

The answer is yes. Obstructive sleep apnea syndrome, or simply sleep apnea, is a disease process caused by repeated episodes of the closing of the upper airway during sleep, resulting in the reduction of airflow and oxygen to the lungs. This can lead to low oxygen levels in the bloodstream, gasping episodes, and frequent nighttime awakenings.

Most people with obstructive sleep apnea snore loudly, stop breathing during sleep and have episodes of gasping, choking, gagging, and coughing.

Often, the person isn’t aware that he is waking up dozens of times during the night as a result of trouble breathing, but these episodes lead to restless sleep and therefore daytime fatigue, regardless of how many hours the person tries to sleep.

Woman using CPAP mask
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The Link Between Sleep Apnea and Asthma

Studies suggest that people with asthma may be at increased risk for sleep apnea and that sleep apnea can worsen asthma. Sleep apnea worsens asthma in a number of ways, such as increasing acid reflux, contributing to weight gain and obesity, causing decreased airflow in the airways of the lungs, and may cause increased inflammation throughout the body (including the lungs).

Sleep apnea can cause and/or worsen acid reflux, probably by decreasing the ability of the sphincter muscles in the esophagus to keep acid in the stomach. And, sleep apnea may cause an increase in the amount of inflammatory chemicals in the bloodstream, which could worsen the inflammation in the lungs caused by asthma. These inflammatory chemicals also contribute to weight gain and obesity, which further worsens asthma.

How CPAP Helps

CPAP is the gold standard treatment for obstructive sleep apnea. It is a machine that provides a constant flow of pressurized air that works to maintain an open airway via a fitted mask. CPAP has been used to treat sleep apnea since 1981. It is also effective in eliminating snoring. Although there are many different manufacturers of CPAP equipment, each unit consists of the same basic components.

The CPAP machine has a small motor, and takes in room air and generates the air pressure (or pneumatic splint) that is the mainstay of treating sleep apnea. Newer units are small, often smaller than a loaf of bread, and relatively quiet.

CPAP seems to reverse many of the harmful effects of sleep apnea. Acid reflux is improved with the use of CPAP through the increase in the ability of sphincter muscles in the esophagus to keep acid in the stomach. Inflammatory chemicals caused by sleep apnea decrease, causing less inflammation within the body and the lungs.

Airflow within the airways is increased with the use of CPAP, leading to better oxygenation of the lungs and decreased contraction of the smooth muscles around the airways. All of these effects lead to an improvement in asthma control in people with asthma and sleep apnea.

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