Asthma and sleep apnea
Asthma, like obstructive sleep apnea, is a widespread condition. In Switzerland, around one in ten children and one in fourteen adults has asthma; estimates suggest one in five people has sleep apnea.
Asthma and sleep apnea are two conditions that share one thing: breathing doesn’t work the way it should. A serious problem—especially critical when asthma and sleep apnea occur at the same time.
On this page, you’ll learn how asthma and sleep apnea present when combined and why, as someone with asthma, you should always have obstructive sleep apnea medically evaluated. Because: the combination of asthma + sleep apnea is not something to take lightly.
Asthma and sleep apnea
“Asthma and sleep apnea influence each other. Nighttime breathing pauses worsen oxygen deficiency and can significantly intensify asthma symptoms. Especially in asthma patients with snoring or pronounced daytime fatigue, a coexisting sleep apnea should always be considered and specifically evaluated.”
Prof. Dr. M. Spielmanns
What you should know about asthma and sleep apnea
What causes bronchial asthma?
Do people with asthma develop sleep apnea more often than healthy people?
A research group at the Wisconsin School of Medicine and Public Health showed that people with asthma develop sleep apnea significantly more often than healthy people, especially from the age of 36. In addition, breathing pauses in asthma patients are often more severe. That’s why, with nighttime shortness of breath, loud snoring, or pronounced exhaustion, a sleep-medicine evaluation should always be considered.
Which asthma symptoms can worsen due to sleep apnea?
Many typical asthma symptoms can worsen with sleep apnea. Because asthma is a chronic airway disease in which the bronchial mucosa becomes inflamed and narrowed. Common symptoms are coughing, wheezing, shortness of breath, and a feeling of tightness in the chest. Nighttime oxygen deprivation caused by sleep apnea can make these symptoms occur more often or become more intense. Repeated attacks may also be promoted.
What role do medications such as beta-2 agonists play in asthma combined with sleep apnea?
To treat asthma (including in combination with sleep apnea), medications such as beta-2 agonists are often used. They quickly widen the bronchi and help in acute shortness of breath. They are especially important when an asthma attack is likely, but they do not replace long-term anti-inflammatory control. With coexisting sleep apnea, the overall therapeutic approach should be reviewed regularly and adjusted if needed. A medical therapy update is advisable, for example, when nighttime symptoms, snoring, or pronounced daytime fatigue persist despite treatment.
When is asthma and sleep apnea a medical emergency?
If sleep apnea or asthma patients develop severe breathing distress, marked shortness of breath, bluish lips, or chest tightness, this may be a medical emergency. If an asthma attack does not subside despite inhaling fast-acting medication, or symptoms suddenly worsen significantly, immediate medical help should be sought. If you are affected by both conditions, please keep a personal emergency plan available so you and/or your relatives can respond quickly and correctly during acute attacks.
How can someone with asthma tell whether they also have sleep apnea?
If, in addition to asthma symptoms, breathing pauses and snoring occur frequently at night, these are indications of obstructive sleep apnea in asthma patients. These breathing stoppages can last over a minute and often end with an explosive snoring sound when breathing abruptly resumes.
Asthma + sleep apnea is a risky combination
While asthma mainly affects the lower airways, sleep apnea blocks the upper airways during sleep, often because the tongue, due to an unfavorably developed lower jaw, falls backward and seals the airflow like a cork. Together, this leads to pronounced oxygen deficiency. For people with asthma, this is particularly problematic, because their airways are already chronically inflamed and hypersensitive. That makes it all the more important to take action as quickly as possible.
Anyone who suffers from both conditions therefore needs especially careful medical evaluation. Alongside optimizing asthma therapy, it is of great interest to eliminate the mechanical cause of nighttime breathing pauses, such as through surgery. Because only if the upper airways remain open permanently can the lungs be supplied with enough oxygen at night.
A procedure is often used in which the airways are significantly widened by targeted repositioning of the jaws. This increases space in the throat, prevents the tongue from falling backward, and removes sleep-related blockages.
For many affected people, this intervention means not only an end to snoring and breathing pauses, but also noticeable relief for the cardiovascular system and better control of nighttime asthma symptoms.
The earlier the combination of sleep apnea and asthma is recognized and treated, the better other serious secondary diseases such as diabetes, high blood pressure, heart attack, or stroke can be prevented.
Asthma + Schlafapnoe ist eine riskante Kombination
Während Asthma vor allem die unteren Atemwege betrifft, blockiert Schlafapnoe im Schlaf die oberen Atemwege – häufig, weil die Zunge infolge eines ungünstig entwickelten Unterkiefers nach hinten fällt und den Luftstrom wie ein Korken verschliesst. In Kombination führt beides zu ausgeprägtem Sauerstoffmangel. Für Asthmatikerinnen und Asthmatiker ist das besonders problematisch, da ihre Atemwege ohnehin chronisch entzündet und überempfindlich sind. Umso wichtiger ist es, schnellstmöglich gegenzusteuern.
Wer gleichzeitig unter den beiden Erkrankungen leidet, benötigt deshalb eine besonders sorgfältige medizinische Abklärung. Neben der optimalen Einstellung der Asthmatherapie ist es von grossem Interesse, die mechanische Ursache der nächtlichen Atemaussetzer zu beseitigen – etwa durch eine Operation. Denn nur wenn die oberen Atemwege dauerhaft offen bleiben, kann die Lunge nachts ausreichend mit Sauerstoff versorgt werden.
Oft kommt ein Verfahren zum Einsatz, bei dem durch eine gezielte Neupositionierung der Kiefer die Atemwege deutlich erweitert werden. Dadurch wird der Platz im Rachenraum vergrössert, die Zunge kann nicht mehr nach hinten fallen und die Blockaden im Schlaf verschwinden.
Für viele Betroffene bedeutet dieser Eingriff nicht nur ein Ende des Schnarchens und der Atemaussetzer, sondern auch eine spürbare Entlastung des Herz-Kreislauf-Systems sowie eine bessere Kontrolle der nächtlichen Asthmasymptome.
Je früher die Kombination Schlafapnoe und Asthma erkannt und behandelt wird, desto besser lassen sich andere schwere Folgeerkrankungen wie Diabetes, Bluthochdruck, Herzinfarkt oder Schlaganfall verhindern.