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Meta-analysis finds childhood asthma linked to higher risk of obstructive sleep apneaMeta-analysis links childhood asthma to higher risk of sleep apnea

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Key Takeaway
Consider screening children with asthma for obstructive sleep apnea, especially in America and Asia.

This meta-analysis examined the association between childhood asthma and obstructive sleep apnea (OSA) in children, pooling data from studies conducted in the United States, Europe, and Asia. The overall analysis showed a significant association, with an odds ratio of 1.66 (95% CI, 1.21-2.26; p < 0.001).

Subgroup analyses by study design revealed a significant association in cohort studies (OR 2.00; 95% CI, 1.35-2.96) but not in case-control studies (OR 0.85; 95% CI, 0.32-2.28). Cross-sectional studies showed a non-significant trend (OR 1.55; 95% CI, 0.69-3.44).

Geographic variation was noted, with the strongest associations in America (OR 1.99; 95% CI, 1.35-2.96) and Asia (OR 1.64; 95% CI, 1.19-2.25), while Europe showed a nonsignificant trend (OR 0.91; 95% CI, 0.34-2.42).

The authors acknowledge limitations including non-significant findings in case-control studies and the European subgroup. Egger's test (p = .587) indicated no significant publication bias. The authors suggest that integrated screening and management strategies are warranted, particularly in high-risk regions such as America and Asia.

This meta-analysis examined the link between childhood asthma and obstructive sleep apnea across studies in the United States, Europe, and Asia. The researchers combined data to see if having asthma makes sleep apnea more likely in kids.

The results show a significant association between the two conditions. Children with asthma had an increased risk of sleep apnea compared to those without it. The link was strongest in studies from America and Asia. In Europe, the trend was not statistically significant.

The study notes that case-control designs did not show a significant link. Because the evidence comes from a meta-analysis of observational data, it shows an association rather than proving one condition causes the other. The authors suggest that integrated screening and management strategies are warranted, particularly in high-risk regions. Readers should understand this highlights a connection that may help doctors identify at-risk children.

What this means for you:
Children with asthma have a higher risk of obstructive sleep apnea, especially in America and Asia.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
The study was to systematically evaluate the correlation between childhood asthma and obstructive sleep apnea (OSA). Several medical literature data bases were searched for studies published up to March 2025, by using the keywords "asthma" and "obstructive sleep apnea" and "child*." We included observational studies, children with OSA diagnosed polysomnography, clinical criteria, or validated tools; and asthma confirmed by physician diagnosis, medication use, or validated questionnaires and international code. Eleven studies were included that covered populations in the United States, Europe, and Asia. The pooled odds ratio (OR) for the association between childhood asthma and OSA was 1.66 (95% confidence interval [CI], 1.21-2.26; p < 0.001). Subgroup analysis by study design showed significant associations in cohort (OR 2.00 [95% CI, 1.35-2.96]) and cross-sectional (OR 1.55 [95% CI, 0.69-3.44]) but not in case-control studies (OR 0.85 [95% CI, 0.32-2.28]). Geographically, the association was strongest in America (OR 1.99 [95% CI, 1.35-2.96]) and Asia (OR 1.64 [95% CI, 1.19-2.25]), with a nonsignificant trend in Europe (OR 0.91 [95% CI, 0.34-2.42]). Sensitivity analyses directionally consistent with the results, and Egger's test (p = .587) indicated no significant publication bias. Childhood asthma is significantly associated with an increased risk of OSA, with sleep disorders likely exacerbating this relationship. Integrated screening and management strategies are warranted, particularly in high-risk regions such as America and Asia.
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