Use of continuous positive airway pressure reduces airway reactivity in adults with asthma

Michael Busk, Nancy Busk, Paula Puntenney, Janet Hutchins, Zhangsheng Yu, Susan J. Gunst, Robert S. Tepper

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Asthma is characterised by airway hyperreactivity, which is primarily treated with badrenergic bronchodilators and anti-inflammatory agents. However, mechanical strain during breathing is an important modulator of airway responsiveness and we have previously demonstrated in animal models that continuous positive airway pressure (CPAP) resulted in lower in vivo airway reactivity. We now evaluated whether using nocturnal CPAP decreased airway reactivity in clinically-stable adults with asthma. Adults with stable asthma and normal spirometry used nocturnal CPAP (8-10 cmH2O) or sham treatment (0-2 cmH2O) for 7 days. Spirometry and bronchial challenges were obtained before and after treatment. The primary outcome was the provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 s (PC20). The CPAP group (n=16) had a significant decrease in airway reactivity (change in (D)logPC20 0.406, p<0.0017) while the sham group (n=9) had no significant change in airway reactivity (δlogPC20 0.003, p=0.9850). There was a significant difference in the change in airway reactivity for the CPAP versus the sham group (δlogPC20 0.41, p<0.043). Our findings indicate that chronic mechanical strain of the lungs produced using nocturnal CPAP for 7 days reduced airway reactivity in clinically stable asthmatics. Future studies of longer duration are required to determine whether CPAP can also decrease asthma symptoms and/or medication usage.

Original languageEnglish (US)
Pages (from-to)317-322
Number of pages6
JournalEuropean Respiratory Journal
Volume41
Issue number2
DOIs
StatePublished - Feb 1 2013

Keywords

  • Bronchial challenge
  • Chronic mechanical strain
  • Continuous positive airway pressure
  • Lung function

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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