Sleep quality and asthma control and quality of life in non-severe and severe asthma

Abstract

Purpose: The effect of sleep quality on asthma control independent from common comorbidities like gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA) is unknown. This study examined the association between sleep quality and asthma control and quality of life after accounting for OSA and GERD in non-severe (NSA) and severe (SA) asthma.

Methods: Cross-sectional data from 60 normal controls, 143 with NSA, and 79 with SA participating in the Severe Asthma Research Program was examined. Those who reported using positive airway pressure therapy or were at high risk for OSA were excluded.

Results: Both SA and NSA had poorer sleep quality than controls, with SA reporting the worst sleep quality. All asthmatics with GERD and 92% of those without GERD had poor sleep quality (p = 0.02). The majority (88-100%) of NSA and SA participants who did not report nighttime asthma disturbances still reported having poor sleep quality. In both NSA and SA, poor sleep quality was associated with worse asthma control and quality of life after controlling for GERD and other covariates.

Conclusions: These results suggest that poor sleep quality is associated with poor asthma control and quality of life among asthmatics and cannot be explained by comorbid GERD and nighttime asthma disturbances.

Fig. 1

Pittsburgh Sleep Quality Index scores for those without nighttime asthma disturbances. Nighttime asthma disturbances represent 3 items from the Asthma Quality of Life Questionnaire (i.e., “woken at night by your asthma”, “asthma interfered with getting a good night’s sleep”, and sleep chosen as one of the top 5 most important activities limited by asthma) and 1 item from a SARP-specific questionnaire (i.e., “nighttime asthma symptoms: waking from sleep, nighttime use of albuterol, early morning chest tightness). *No nighttime asthma disturbances reported for all 4 items.