Is Asthma Affecting Your Patient’s Sleep and Quality of Life?

Is Asthma Affecting Your Patient’s Sleep and Quality of Life?

This evidence-based research suggests asthma patients experience poorer sleep quality and quality of life 

The following article is a synopsis of this published research:

Luyster F, Teodorescu M, Bleecker E, Busse W, Calhoun W, Castro M, Chung KF, MD, Erzurum S, Israel E, Strollo F, Wenzel S. Sleep Quality and Asthma Control and Quality of Life in Non-Severe and Severe Asthma. Sleep Breath. 2012; Dec; 16(4): 1129–1137. Published online 2011 Nov 20. The full article is available HERE.

This study explored the relationship between sleep quality and asthma control and quality of life independent of common comorbidities such as gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA) in both non-severe (NSA) and severe (SA) asthma. As a chronic inflammatory disease of the airways, asthma is characterized by reversible airflow obstruction and bronchial hyperresponsiveness. The authors’ hypothesis that poorer sleep quality is independently associated with worse asthma control and quality of life, and that poor sleep quality cannot be entirely explained by GERD, OSA, or nighttime asthma disturbances was correct.

Results showed that the majority of patients with asthma evaluated had poor sleep quality regardless of the presence of GERD symptoms and nighttime asthma disturbances. In both NSA and SA, poorer sleep quality was an independent predictor of worse asthma control and quality of life after accounting for GERD and other associated co-variables, and these patients also reported worse sleep quality than patients in the control group without asthma. Severe-asthma patients experienced worse asthma control and asthma quality of life as compared to those with NSA.

Sixty non-asthma participants, 143 participants with NSA, and 79 participants with SA who were actively taking part in the Severe Asthma Research Program were examined via cross-sectional data for a total of 282 participants. Adults under the age of 18 and those who reported using positive airway pressure therapy or who were at high risk for OSA were excluded. All participants completed comprehensive questionnaires, allergy skin testing and blood collection for complete blood counts and differentials and total IgE level. Additionally, exhaled nitric oxide was documented and pulmonary function testing, including baseline and post-bronchodilator spirometry and a methacholine challenge, was also conducted.

These findings suggest that considering sleep as a factor affecting asthma control is noteworthy. Improvements in sleep quality were associated with improvements in asthma control and quality of life over a six-month period in mild-moderate asthmatics with poorly controlled asthma. Since poorly-controlled asthma is associated with work loss productivity, activity limitations, and increased healthcare utilization and costs, identifying poor sleep as an independent risk factor has important implications in the clinical management of patients with asthma.

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