Asthma and impaired sleep: identifying treatable traits in the SCAPIS Study

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Aims: This study compared sleep quality and insomnia in adults with and without asthma, identifying treatable traits to improve sleep in asthma. Methods: This cross-sectional analysis included 28,828 participants (aged 50–64) from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Post-bronchodilator FEV1 and FVC were measured. Questionnaires assessed physician-diagnosed asthma, symptoms, exacerbations, allergic rhinitis, chronic rhinosinusitis (CRS), nocturnal gastroesophageal reflux (GER), snoring, sleep apnea, and sleep quality. Insomnia symptoms included difficulties initiating (DIS), maintaining (DMS) sleep, and early morning awakening (EMA). Results: Current asthma (6.3%) was associated with impaired sleep quality (OR=1.56; 95%CI: 1.39–1.75), DIS (OR=1.59; 1.40–1.80), DMS (OR=1.36; 1.22–1.51), EMA (OR=1.31; 1.16–1.47), and any insomnia symptom (OR=1.37; 1.25–1.52). Among asthma patients, allergic rhinitis was associated with impaired sleep (OR=1.28; 1.01–1.62), and CRS with impaired sleep (OR=2.22; 1.65–2.98) and insomnia. Asthma symptoms and exacerbations were associated with impaired sleep and insomnia. Nocturnal GER (OR=1.72 to 2.23), snoring (OR=1.39 to 1.55), and sleep apnea (OR=1.45 to 2.15) were linked to impaired sleep and insomnia. A low FEV1/FVC ratio was linked to EMA. Uncontrolled asthma, CRS, and nocturnal breathing disorders increased the odds of impaired sleep and insomnia, with the strongest associations in those with all three conditions (sleep, OR=5.66; insomnia, OR=3.62). Conclusions: Asthma is linked to impaired sleep and insomnia. These sleep issues are associated with three treatable traits: poor asthma control, upper airway disorders, and nocturnal breathing disorders.

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