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Short sleep duration: A potential risk factor for acute asthma exacerbations

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Dr Surya Kant, Professor and Head, Dept. of Respiratory Medicine, KGMU, UP, Lucknow. National Vice Chairman IMA-AMS    02 February 2023

Patients with asthma who sleep for short durations each night are at significantly higher risk of moderate-to-severe asthma exacerbations, according to a study published in Journal of Allergy and Clinical Immunology: In Practice.1,2

 

This prospective study sought to examine if duration of sleep correlated with clinical and inflammatory features of asthma. Additionally, they also investigated the association of sleep duration with acute exacerbations of asthma over a follow-up period of one year. For this, 522 adult patients with stable asthma visiting a hospital were recruited from January 2015 to September 2019. Fifty-eight patients reported sleeping for less than 6 hours per night (short sleep duration), 380 reported sleeping for 6-8 hours per night (normal sleep duration), while 84 slept for more than 8 hours per night (long sleep duration). Information about moderate to severe acute exacerbations was obtained via in-person or telephonic interviews.

 

Results showed that compared to patients who slept for normal duration, those who slept for shorter duration each night were older in age (44 years vs 53 years) and had significantly lower total immunoglobulin E (146.00 vs 76.63 IU/mL) and fractional exhaled nitric oxide (FeNO) (41 vs 25 ppb) levels. High levels of interleukin (IL)-6  and tumor necrosis factor (TNF)-α in sputum in these patients were indicative of the increased airway inflammation vs patients with normal sleep duration. Fewer patients in short sleep duration group had type 2 asthma vs the normal and long sleep duration groups; 44.8% vs 69.7% vs 64.3%, respectively

 

At one year, 132 (~27%) of the 491 patients who completed the 1-year follow-up experienced moderate-to-severe acute exacerbations. Patients in the short sleep duration group were nearly 3 times more likely to have poorly controlled asthma with aOR of 2.74. Their risk of experiencing moderate to severe asthma exacerbations also doubled with an adjusted incidence rate ratio of 1.79.

 

This study found that participants with self-reported short duration of sleep were older in age and were more at risk of developing moderate to severe acute exacerbations. The airway inflammation was non-type 2 or non-eosinophilic in nature. These findings indicate that short sleep duration as an independent risk factor for acute exacerbations, which is potentially manageable and enhances quality of life by improving asthma control.

 

References

 

  1. Wang CY, et al. Self-reported insufficient sleep is associated with clinical and inflammatory features of asthma: a prospective cohort study. J Allergy Clin Immunol Pract. 2022 Dec 26;S2213-2198(22)01324-1. doi: 10.1016/j.jaip.2022.12.011.
  2. Colby Stong. https://www.pulmonologyadvisor.com/home/topics/asthma/short-sleep-duration-is-risk-factor-for-poorly-controlled-asthma/, Jan. 30, 2023. Accessed on Jan. 31, 2023.

 

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