ABSTRACT
The objective of the present study was to investigate the level of asthma control in real life and the relationship between Asthma Control Test (ACT) scores and sleep disturbances. Patients on control visits for bronchial asthma were asked to complete the ACT questionnaire and to answer 5 questions about their sleep quality (S5). It was found that asthma control was unsatisfactory in 44%. In all ACT classes the level of asthma control appeared to be inversely related to the presence of sleep disturbances: patients with good control reported less frequent and less severe sleep disturbances than uncontrolled subjects. However, a significant percentage of subjects (11-20%) with total control of asthma still had sleep disturbances that resulted in an impaired quality of life. Therefore in any asthma case with sleep disturbances a broader investigation is required whether that impairment is actually a result of asthma or some other co-morbidity. Thus it would be useful if patients who reported sleep disturbances despite good/total control of asthma and rhinitis were managed with a holistic clinical approach and underwent nocturnal polysomnographic monitoring.
Subject(s)
Asthma/physiopathology , Sleep Wake Disorders/physiopathology , Sleep , Adolescent , Adult , Aged , Asthma/complications , Asthma/epidemiology , Female , Humans , Male , Middle Aged , Polysomnography , Rhinitis, Allergic, Seasonal/complications , Rhinitis, Allergic, Seasonal/epidemiology , Rhinitis, Allergic, Seasonal/physiopathology , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Surveys and QuestionnairesABSTRACT
BACKGROUND: The goal of asthma therapy is to achieve an optimal level of disease control, but the relationship between asthma control, impact of comorbid rhinitis and health related quality of life (HRQoL) in real life remains unexplored. OBJECTIVE: The aims of this real life study were to evaluate asthma control, the impact of asthma (with and without rhinitis) on HRQoL, the relationship between asthma control and HRQoL, and the role of rhinitis on asthma control and HRQoL. METHODS: 122 asthma patients completed the Asthma Control Test, Rhinitis Symptoms score (T5SS) and RHINASTHMA. RESULTS: Asthma control was unsatisfactory (44.27% of uncontrolled patients), as well as HRQoL. Controlled patients controlled showed significantly lower scores in all the RHINASTHMA domains compared to uncontrolled. Irrespective of their level of control, patients with rhinitis symptoms showed worse HRQoL in Upper Airways (UA) (P < 0.0001), Lower Airways (LA) (P < 0.001), and Global Summary (GS) (P < 0.0001). In patients with symptomatic rhinitis, RHINASTHMA were lower in controlled asthma patients (UA P = 0.002; LA P < 0.0001; RAI P < 0.01; GS P < 0.0001). Asthma control was associated with lower T5SS score (P = 0.034). CONCLUSION: Asthma control in real life is unsatisfactory. Rhinitis and asthma influence each other in terms of control and HRQoL. The control of rhinitis in asthma patients can lead to an optimization of HRQoL related to the upper airways, while this phenomenon is not so evident in asthma. These results suggest to strengthen the ARIA recommendation that asthma patients must be evaluated for rhinitis and vice versa.
Subject(s)
Asthma/psychology , Asthma/therapy , Quality of Life , Adolescent , Adult , Aged , Comorbidity , Female , Forced Expiratory Volume , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
Respiratory tract infections (RTIs) represent a serious problem because they are one of the most common cause of human death by infection. The search for the treatment of those diseases has therefore a great importance. In this study we provide an overview of the currently available treatments for RTIs with particular attention to chronic obstructive pulmonary diseases exacerbations and recurrent respiratory infections therapy and a description of bacterial lysate action, in particular making reference to the medical literature dealing with its clinical efficacy. Those studies are based on a very large number of clinical trials aimed to evaluate the effects of this drug in maintaining the immune system in a state of alert, and in increasing the defences against microbial infections. From this analysis it comes out that bacterial lysates have a protective effect, which induce a significant reduction of the symptoms related to respiratory infections. Those results could be very interesting also from an economic point of view, because they envisage a reduction in the number of acute exacerbations and a shorter duration of hospitalization. The use of bacterial lysate could therefore represent an important means to achieve an extension of life duration in patients affected by respiratory diseases.
