A significant correlation was seen between quality of sleep and asthma control in patients with asthma, according to study results published in the Journal of Asthma. This relationship highlights the importance of clinicians screening for poor sleep quality in this patient population.

This large observational cross-sectional study was designed to estimate the prevalence of poor sleep quality in patients with asthma across 30 specialist centers in Italy and examine the relationships between sleep impairments, sociodemographic characteristics, asthma control, and rhinitis symptoms. Data from 1150 participants with asthma (mean age, 51.01 ±16.03 years) were included for analysis, 59.8% of whom had well controlled or totally controlled asthma. Overall, 58.3% of participants had poor sleep quality, defined as a Pittsburgh Sleep Quality Index (PSQI) total score ≥5, with a mean PSQI score of 5.68. The domains primarily contributing to scores indicating worse sleep quality were overall sleep quality, daytime dysfunctions resulting from sleepiness, and sleep disturbances. No difference was seen between the PSQI scores of participants with and without allergic rhinitis.

Severity of asthma was significantly associated with quality of sleep (F=3.84; P =.004). A significant correlation was seen between quality of sleep and asthma control (r=0.414; P =.0001), and a weak correlation was seen between PSQI total score and Total 5 Symptoms Score (T5SS; r=0.24; P =.0001). Uncontrolled asthma, defined as an asthma control test (ACT) score <20, was associated with 3.3 times higher odds of having poor sleep quality (95% CI, 2.57-4.26; P <.001). A significant association was seen between sleep quality and health-related quality of life (HRQOL; r=0.50; P <.001). Overall, the most important predictors of PSQI score were ACT scores (β=-0.288; P <.001) followed by gastroesophageal reflux disease impact scale (GIS) scores (β=-.215; P <.001), and T5SS (β=-.288; P <.001). The most important predictor of HRQOL scores were ACT scores (β=‑.463; P <.001).

The investigators concluded that despite the limitations inherent to a cross-sectional observational study, these findings highlight how prevalent sleep impairments are in patients with asthma, as well as the relationship between sleep and asthma severity, control, and HRQOL.

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“Although future studies that examine a wider range of variables are needed, the present results underscore the need for physicians to detect poor sleep quality among their patients,” the researchers wrote. “An increased attention to assessment of sleep disturbances may help to drive choices and interventions for the achievement of asthma outcomes.”


Braido F, Baiardini I, Ferrando M, et al. The prevalence of sleep impairments and predictors of sleep quality among patients with asthma [published online January 12, 2020]. J Asthma. doi:10.1080/02770903.2019.1711391