Self-Reported Insufficient Sleep Is Associated With Clinical and Inflammatory Features of Asthma: A Prospective Cohort Study

Chang Yong Wang; Ji Wang; Li Zhang; Shu Wen Zhang; Lei Wang; Shu Zhen Zhao; Zhi Hong Chen; Xin Zhang; Min Xie; Ting Wang; Alan Chen-Yu Hsu; Lin Qin; Brian G Oliver; Lei Liu; Hua Jing Wan; Dan Liu; Feng Ming Luo; Wei Min Li; Gang Wang

doi:10.1016/j.jaip.2022.12.011

Self-Reported Insufficient Sleep Is Associated With Clinical and Inflammatory Features of Asthma: A Prospective Cohort Study

J Allergy Clin Immunol Pract. 2023 Apr;11(4):1200-1210.e4. doi: 10.1016/j.jaip.2022.12.011. Epub 2022 Dec 26.

Authors

Chang Yong Wang¹, Ji Wang¹, Li Zhang², Shu Wen Zhang², Lei Wang³, Shu Zhen Zhao⁴, Zhi Hong Chen⁵, Xin Zhang³, Min Xie⁶, Ting Wang⁷, Alan Chen-Yu Hsu⁸, Lin Qin⁹, Brian G Oliver¹⁰, Lei Liu², Hua Jing Wan¹, Dan Liu¹, Feng Ming Luo¹, Wei Min Li¹¹, Gang Wang¹²

Affiliations

¹ Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China.
² Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
³ Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
⁴ Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
⁵ Shanghai Institute of Respiratory Disease, Respiratory Division of Zhongshan Hospital, Fudan University, Shanghai, China.
⁶ Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
⁷ Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
⁸ Duke-NUS Medical School, Singapore.
⁹ Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
¹⁰ School of Life Sciences, University of Technology Sydney, Ultimo, New South Wales, Australia; Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.
¹¹ Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China. Electronic address: [email protected].
¹² Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China. Electronic address: [email protected].

PMID: 36581067
DOI: 10.1016/j.jaip.2022.12.011

Abstract

Background: A few studies have explored the association between short sleep duration and worse asthma outcomes in patients with self-reported asthma; however, all of them were cross-sectional.

Objectives: To investigate the association between self-reported sleep duration and asthma-related clinical and inflammatory characteristics and whether sleep duration is associated with asthma exacerbations (AEs) in the following year.

Methods: A prospective cohort study consecutively recruited participants with asthma, who were classified into short (n = 58), normal (n = 380), and long (n = 84) sleep duration groups. We investigated the clinical and inflammatory characteristics and exacerbations within a 1-year follow-up.

Results: Patients with short sleep duration were older and had significantly lower total IgE and FeNO levels and higher airway inflammation, characterized by increased levels of IL-6 and TNF-α in sputum than those of patients with normal sleep duration. Furthermore, they had a significantly increased risk for poorly controlled asthma (adjusted odds ratio = 2.741; 95% CI, 1.379-5.447; P = .004) and moderate to severe AEs (adjusted incidence rate ratio = 1.798; 95% CI, 1.098-2.942; P = .020).

Conclusions: Short sleep duration was associated with non-type 2 inflammation and is an independent risk factor for future AEs. Therefore, as a potentially treatable trait, sleep duration may have clinical implications for asthma management.

Keywords: Asthma; Asthma control; Exacerbation; Sleep duration.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Asthma* / epidemiology
Humans
Inflammation / epidemiology
Prospective Studies
Self Report
Sleep Deprivation*