<p>The Association Between Sleep Duration, Asthma-Related Episodes/Attacks and Emergency Department Visits</p>

Abstract

Background: Inadequate sleep duration potentially increases the risk of allergic asthma; yet, the effect of different sleep duration on asthma-related episodes/attacks and emergency department (ED) visits has remained unclear. The purpose of this study is to evaluate the association between sleep duration, asthma-related episodes/attacks and ED visits. Methods: This study included 1526 asthma participants from the Behavioral Risk Factor Surveillance System Questionnaire during 2013-2017. Self-reported sleep duration was classified into three groups: ≤6 h (short), 7 h to 8 h (optimal) and ≥9 h (long). Generalized additive model with binomial or Poisson regression was used to complete all statistical analyses. Results: During a 12-month period, 857 participants reported acute episodes/attacks of asthma, and 279 participants reported asthma-related ED visits. Asthmatics with ED visits harbored significantly lower mean sleep duration (6.50 h vs 7.01 h, adjusted OR=0.93, 95% CI: 0.88-0.98) than those without episodes/attacks. After adjusting the potential confounding factors, the participants with long sleep duration were associated with lower risk of asthmarelated episodes/attacks (adjusted OR=0.59, 95% CI: 0.41-0.86) than those with short sleep duration. The prevalence (adjusted OR=0.67, 95% CI: 0.47-0.94) and frequency (adjusted OR=0.83, 95% CI: 0.69-0.9996) of asthma-related ED visits among short sleepers were significantly higher than that among optimal sleepers. The differences of asthma-related episodes/attacks and ED visits between long and optimal sleepers were statistically insignificant. Conclusion: Our study demonstrated that asthmatics with short sleep duration were associated with highest prevalence of asthma-related episodes/attacks and ED visits among the three sleep duration groups.

The Effect of Short Sleep Duration on the Development of Asthma

“…The prevalence of short sleep duration (≤6 h) ranged from 45% to 50.8% in three studies about asthmatics [ 13 – 15 ], which seemed to be higher than that in the general population. Our previous study also observed that the prevalence of short sleep duration is gradually increasing with the deterioration of asthmatic clinical outcomes [ 14 ]. Short sleep duration may result in some complications such as chronic low-grade inflammation, obesity, and immune dysfunction (see Figure 1 ), which potentially affect the development and acute exacerbation of asthma and lung function impairment.…”

“…Compared with normal sleep duration, short sleep duration seemed to significantly increase the risk of depressive symptoms (adjusted OR = 1.26, 95% CI: 1.11–1.44). Our previous study about the association between sleep duration and asthmatic episodes/attacks had the data about depression in asthmatics [ 14 ]. Secondary analysis was performed to determine the difference in depression between short and healthy sleep duration in asthmatics.…”

“…The study by Teodorescu et al found that very short habitual sleep (<6 h) is associated with higher asthma steps (OR = 2.77, 95% CI: 1.71–4.49) and more persistent (step ≥ 2) asthma (OR = 2.69, 95% CI: 1.53–4.71) [ 27 ]. Two existing studies assessed whether short sleep duration affects the risk of asthma-related symptoms and acute attacks [ 14 , 41 ]. Compared to normal sleep duration (6–8 h), short sleep duration (≤5 h) potentially increased the risks of asthma-related attacks (adjusted OR = 1.58, 95% CI: 1.13–2.21), asthma-related cough (adjusted OR = 1.95, 95% CI: 1.32–2.87), and asthma-related hospitalization (adjusted OR = 2.14, 95% CI: 1.37–3.36) [ 41 ].…”

“…In addition, short sleep duration had negative effects on the patient's daily life, mental health, and activity ability. Another study involving 1,526 asthmatics assessed the effects of short sleep duration on the prevalence of asthma-related attacks and emergency visits and the number of asthma-related emergency care visits [ 14 ]. Compared with short sleep duration (≤6 h), healthy sleep duration (7-8 h) was associated with a significant reduction in the prevalence (adjusted RR = 0.67, 95% CI: 0.47–0.94) and number (adjusted RR = 0.83, 95% CI: 0.69–0.9996, P =0.0495) of asthma-related emergency care visits.…”

Associations Between Incident Asthma With Comorbidity Profiles, Night Sleep Duration, and Napping Duration Trajectories: A 7-Year Prospective Study

“…Comorbidity profiles potentially affect asthma severity and asthma control levels and brings increased attention to asthma management [7]. The cross-sectional studies indicated that short sleep duration may increase the prevalence of asthma [8], the frequency of asthma-related emergency department visits [9], and lung function impairment [10]. However, only one prospective study has explored the effect of different sleep duration trajectories from adolescence into adulthood on incident asthma in young adults aged 24-32 years [11].…”