Poor asthma control tied to impaired sleep

Poor sleep quality is common among patients with asthma, particularly in those who have suboptimal control of the condition, reports a new study.

Two hundred asthma patients (mean age, 50.6±17.1 years; 67 percent female) participated in the study. A cross-sectional survey was conducted to assess disease control (Asthma Control Test [ACT]) and sleep quality (Pittsburgh sleep quality index [PSQI], Epworth sleepiness scale [ESS], Berlin questionnaire [BQ], and insomnia severity index [ISI]).

The ACT found that 67 patients had well-controlled asthma and 55 had partially controlled disease; in the remaining 78, asthma was uncontrolled. Groups were comparable in terms of age, sex, and smoking history, but body mass index tended to be lower in participants with well-controlled disease than in the remaining two groups (p=0.008).

All sleep measures also varied significantly across the different disease control categories. For instance, excessive daytime sleepiness, defined as an ESS score >10, occurred more frequently among participants with partially and uncontrolled disease, as opposed to those with well-controlled asthma (27 percent and 36 percent vs 10 percent, respectively; p=0.002).

Similarly, significantly more patients in the partially and uncontrolled disease groups were at high risk for obstructive sleep apnoea, as determined by the BQ (56 percent and 47 percent vs 27 percent, respectively; p=0.003). ISI-defined insomnia was also common in the former two groups (49 percent and 68 percent vs 19 percent; p<0.001).

A PSQI score >5, indicative of poor sleep quality, was significantly rarer among patients with well-controlled asthma (p<0.001). Multivariable analysis confirmed that both partially (B, 5.37, 95 percent confidence interval [CI], 2.25–12.84; p<0.001) and uncontrolled (B, 6.63, 95 percent CI, 2.98–14.75; p<0.001) diseases were significant risk factors for poor sleep.