Adolescents with asthma who practice good sleep hygiene may experience improvements in sleep and attention span, better quality of life in school, and lower rates of dysfunction during the daytime, according to a study published in the Journal of Asthma.

This study included 41 participants with persistent asthma (mean age, 14.83±1.28 years; 51.2% male adolescents). Measures included demographic information (sex, age, race/ethnicity, education, caregiver marital status, and family income), information on asthma, sleep hygiene via the adolescent sleep hygiene scale (ASHS), quality of sleep via the Adolescent Sleep Wake Scale (ASWS), quality of life via the Pediatric Quality of Life Index (PedsQL), and attention span via the psychomotor vigilance task (PVT).

To investigate associations among variables related to asthma, as well as between demographic features and dependent variables, Pearson product-moment correlations were used. The predictive power of sleep hygiene on sleep quality, quality of life (school-related or otherwise), and attention span was calculated using linear regressions. Because the sample size was smaller than the recommended 73 participants, effect sizes were used to interpret results. Cohen’s f² effect sizes were categorized as large (0.35), medium (0.15), or small (0.02).

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None of the adolescents in this study were categorized as having good sleep hygiene, and 90.2% were categorized as having poor sleep hygiene. Adolescents who reported better sleep hygiene were more likely to report better sleep quality (f²=0.166; β=0.377; P =.015), as well as better attention span (f²=0.120; β=0.327; =.045) and better school-related quality of life (f²=0.115; β=0.321; =.04). This translated to 0.616-unit increase in quality of sleep and a 15.001-unit increase in school-related quality of life per 1-unit increase in sleep hygiene.

Limitations to this study included the lack of a control group, a small number of participants with suboptimal response rate, self-reported measures, a lack of acute asthma cases, and a lack of accounting for other factors that can affect sleep quality and hygiene.

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The researchers concluded that “[s]leep hygiene may be an important factor in sleep quality and deficits in daytime dysfunction including sustained attention and school-related quality of life. As adolescents with asthma are at heightened risk for these outcomes associated with disturbed sleep, sleep hygiene may serve as an important domain for clinical intervention.”


Lawless C, Turner EM, LeFave E, Koinis-Mitchell D, Fedele DA. Sleep hygiene in adolescents with asthma [published online December 13, 2018]. J Asthma. doi:10.1080/02770903.2018.1553049