Study Results Find Mood and Sleep Disorders Negatively Impact Asthma Control

According to a recent study published in the Journal of Asthma, there is an association between insomnia, depression, and obstructive sleep apnea in people with asthma. Poor sleep quality, according to the investigators, was previously reported by individuals with asthma—notably those with poor control over their condition—but there is little understanding about how underlying sleep disorders may impact asthma control.^1,2

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“Asthma control, sleep quality, and mood are all critical factors in affecting an individual’s overall quality of life, and our study suggests a strong relationship among all 3 areas,” said senior study author Michael Wechsler, MD, pulmonologist, professor of medicine, and director of The Cohen Family Asthma Institute at National Jewish Health, in a news release. “Individuals with asthma should be regularly screened for sleep quality as well as for co-existing mood disorder.”¹

A total of 659 adult patients with asthma from a large asthma center were enrolled in this retrospective study. The patients enrolled were evaluated based on the presence of concurrent obstructive sleep disorder, mood disorders, asthma exacerbation frequency, and asthma control test scores (ACT). Additionally, the patients with and without an insomnia diagnosis were matched by age, sex, Charlson comorbidity index, and biologic therapy.²

Among the study population, 89 patients with insomnia (13.5%) were matched with patients who did not have insomnia. The study findings demonstrate that, compared with patients who did not have insomnia, patients with difficulty sleeping were more likely to have a simultaneous diagnosis of obstructive sleep apnea (57.3% vs 18%, respectively; p < .001). Additionally, these patients were also more likely to be diagnosed with depression or anxiety (68.5% vs. 11.4%, respectively; p < .001). Further, the investigators also observed that patients with insomnia had an average of .93 asthma exacerbations per year, compared with those without insomnia, who had less frequent exacerbations (average: .59; p = .039). This increased exacerbation rate suggests that underlying sleep and mood disorders have a negative impact on patients with asthma and their ability to control their condition.^1,2

Prior research demonstrated that poor sleep quality is often associated with asthma. A 2011 study found that asthma is often associated with a decreased quality of sleep, difficulties falling asleep, fragmented sleep, early morning awakenings, and increased drowsiness during the daytime. Poor disease control then induces an elevated corticosteroid dosages and systemic treatment requirement, resulting in patients having sleep deprivation. Knowing this, the current study authors wanted to investigate the relationship between depression—which frequently overlaps with insomnia—plus other mood disorders and asthma. Although prior research has examined the association between difficulties sleeping and asthma control, the specific interaction between these conditions and mood disorders had not been well studied.^1,3

Although the current study authors note that the findings demonstrate that there is a noticeable interaction between insomnia, depression, and obstructive sleep apnea in patients who have asthma further research is needed to further understand the mechanisms behind the interactions between asthma, sleep, and depression. A stronger understanding, according to the authors, can help influence guidelines for screening as well as the management of sleep and mental health disorders in patients with asthma.¹

“It is important for us as physicians to treat asthma comorbidities like sleep and mood disorders similarly to what we do with other conditions that impact asthma management, such as reflux, sinus disease and vocal cord dysfunction,” said Wechsler in the press release.¹

References

1. National Jewish Health. Researchers show impact of insomnia and depression on asthma control. News release. May 8, 2024. Accessed May 14, 2024. https://www.eurekalert.org/news-releases/1044053

2. Rhoads, SL, Edinger, J, Khatiwada, A, Zimmer, J, Zelarney, P, Wechsler, ME. The impact of insomnia and depression on asthma control. J Asthma. Published online April 4, 2024. doi:10.1080/02770903.2024.2335367

3. Cukic, V, Lovre, V, Dragisic, D. Sleep disorders in patients with bronchial asthma. Mater Sociomed. 2011;23(4):235-237. doi:10.5455/msm.2011.23.235-237