Sleep Duration Linked to More Asthma Attacks

Faith S. Luyster, PhD

New research shows a distinct relationship between sleep duration and the adverse events associated with asthma.

A team, led by Faith S. Luyster, PhD, University of Pittsburgh School of Nursing, examined the links between sleep duration, patient-reported outcomes, and healthcare use in adults with asthma.

Currently, asthma contributes to significant morbidity and healthcare usage for adults in the US. While research points to insufficient and excessive sleep duration as major contributors to adverse effects on health, there is little known about the impact of sleep duration on health outcomes specifically in adults with asthma.

The investigators used 2007-2012 data from the National Health and Nutrition Examination Survey (NHANES), which included self-reported asthma designations.

They then categorized habitual hours of sleep duration as short (≤5), normal (6-8), and long (≥9) and used multivariate regression analyses to examine the link between sleep duration and patient-reported outcomes and healthcare use.

The investigators found 1389 adults with asthma, 26% of which reported sleep duration, 66% of which reported normal sleep duration, and 8% of which reported long sleep duration.

Some of the demographic information found were that short sleepers were more likely to be younger and non-white, while longer sleepers were more likely to be older, female, and a smoker.

There was a distinct link between sleep duration and various adverse effects related to asthma.

Individuals with short sleep duration had increased asthma attacks (aOR, 1.58; 95% CI, 1.13-2.21, coughing (aOR, 1.95; 95% CI, 1.32-2.87), and overnight hospitalizations (aOR, 2.14; 95% CI, 1.37-3.36) compared to participants with normal sleep duration.

The investigators also reported worse health-related quality of life including days of poor physical health, mental health, and inactivity because of poor health (P <0.05).

On the other hand, those who slept longer had more activity limitation because of wheezing compared to the normal duration sleep group (aOR, 1.82; 95% CI, 1.13-2.91).

According to a 2017 study, individuals who experience difficulties sleeping are much more likely than the general population to develop asthma.

Investigators from the Norwegian University of Science and Technology examined data for 17,927 patients enrolled in the ongoing Nord-Trøndelag Health Study (HUNT). Participants were asthma-free at the study’s inception and all were between the ages of 20-65. Participants were asked at intervals to report problems associated with asthma, according to Linn Beate Strand, PhD, a sleep researcher and last author on the study.

The data from this study suggested a link, showing that patients with symptoms of insomnia were three times more likely to develop asthma over time. The average follow-up with patients in the study was 11 years.

Furthermore, the data suggested that the more severe the insomnia symptoms, the greater the likelihood that an individual patient would develop asthma. Patients who said they “often” have trouble falling asleep at night had a 65% higher risk of developing asthma over time. Those who reported sleep difficulties “almost every night” had a 108% higher risk of asthma.

While sleep is related to the risk of developing asthma, the new study shows the link between sleep duration and the adverse events related to asthma.

“Compared to adults with asthma and normal sleep duration, those with short sleep duration experience more frequent asthma attacks, increased healthcare use, and worse health-related quality of life, whereas those with long sleep duration experience more frequent activity limitation,” the authors wrote.

The study, “Associations of sleep duration with patient-reported outcomes and healthcare use in U.S. adults with asthma,” was published online in the Annals of Allergy, Asthma & Immunology.