Sleep Disorders Are Associated With Asthma

Sleep disorders are associated with an increased prevalence and incidence of asthma, according to a study in BMJ Open Respiratory Research.

Although sleep disorders are commonly reported in patients with asthma, it is uncertain whether having a sleep disorder is a risk factor for asthma or what factors affect the incidence and prevalence of sleep disorders in these patients. Researchers therefore conducted a meta-analysis to explore the relationship between sleep disorders and asthma. The analysis took into account the effects of population specificity, sleep disorder type, and study design.

A literature search was performed in the PubMed, Embase, Cochrane Library, and Web of Science databases for relevant articles published before December 30, 2022. Observational studies that assessed the association between sleep disorders and the incidence or prevalence of asthma were eligible. Sleep disorders considered included insomnia, poor sleep quality, and insufficient sleep duration.

The meta-analysis included 23 studies. In the primary analysis, sleep disorders were associated with an increased incidence or prevalence of asthma (odds ratio [OR], 1.38; 95% CI, 1.10-1.74). A sensitivity analysis demonstrated robust results.

In subgroup analyses, sleep disorders were associated with asthma among the cohort studies (OR, 1.73; 95% CI, 1.16-2.57), and the findings were consistent in the cross-sectional studies (OR, 1.20; 95% CI, 1.14-1.28). Insufficient sleep duration (OR, 1.20; 95% CI, 1.13-1.28) and poor sleep quality were associated with asthma (OR, 1.10; 95% CI, 1.05-1.16).

Sleep disorders were associated with an increased incidence or prevalence of asthma in adults (aged >18 years; OR, 1.36; 95% CI, 1.18-1.57) and in adolescents aged 12 to 18 years (OR, 1.15; 95% CI, 1.08-1.21), but not among children under the age of 12 years (OR, 1.13; 95% CI, 0.97-1.32).

The association between sleep disorders and asthma was significant in studies that did not adjust for family history of asthma (OR, 1.27; 95% CI, 1.18-1.36), and the association was not significant in studies that adjusted for family history of asthma (OR 1.16; 95% CI, 0.94-1.42).

The overall quality of evidence was considered as very low. In the subgroup analyses, evidence grade levels ranged from low to very low.

Among several limitations, the meta-analysis was based on aggregate rather than individual data, and heterogeneity was significant for all outcomes. Also, potential bias reduced confidence in the findings, and in most studies asthma diagnosis and sleep disorders were based on questionnaires.

“[W]e found that sleep disorders were positively associated with asthma,” the study authors concluded. “However, this association was insignificant in studies in which a family history of asthma was adjusted. In addition, this relationship was not significant in children.” More studies are needed to confirm these findings, the researchers added.

This article originally appeared on Pulmonology Advisor