Dysfunctional breathing in patients with severe asthma is associated with poor asthma control and low quality of life

Background: The prevalence of dysfunctional breathing (DB) in patients with severe asthma is only sparsely investigated. However, DB may lead to an overestimation of the severity of asthma symptoms in these patients, and hence potentially to overtreatment. Objective: 1) To investigate the prevalence of DB among patients with severe asthma. 2) To investigate the level of asthma control and quality of life in severe asthma patients with and without DB. Methods: Patients (≥18 years) with potential severe asthma according to the ERS/ATS 2014 guidelines were invited to participate in the SATS study in which potential causes of poor asthma control were systematically investigated including screening for DB with the Nijmegen questionnaire. DB was defined as a Nijmegen score≥23. Results: In total, 120 patients were included in the SATS study. Among these, 31.7 % (38/120) had DB according to the Nijmegen score. DB was found in 40.3 % of females and 18.8 % of males (p=0.013). Patients with DB had a lower asthma control (mean(SD) ACQ:2.81 (1.05) vs. 1.46 (0.93), p Conclusion: Dysfunctional breathing (defined as a Nijmegen-score ≥23) is common in patients with severe asthma and associated with significantly poorer asthma control and lower quality of life. Patients with severe asthma should be routinely screened for dysfunctional breathing.