Healthy sleep patterns reduce risks for asthma
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Key takeaways:
- Patients with poor sleep and high genetic risks had a 122% increased risk for asthma.
- Sleeping for 7 to 9 hours a day reduces risks for asthma by 20%.
- Interventions focused on improving sleep may prevent asthma.
Patients with poor sleep patterns and higher genetic susceptibility have an additive higher risk for asthma, with lower risks among patients with healthy sleep patterns, according to a study published in BMJ Open Respiratory Research.
Early detection and management of sleep disorders could improve asthma management, Bowen Xiang, graduate student, department of biostatistics, Cheeloo College of Medicine School of Public Health, Shandong University, and colleagues wrote.
“We conducted the study primarily based on the fact that some asthma patients tend to have sleep disorders because of breathing issues, which inspired our hypothesis — whether sleep quality would also affect the risk of asthma,” Xiang told Healio.
Sleep disorders and asthma both are associated with breathing issues, Xiang continued, so they may have similar mechanisms.
“This also implies that the relationship between them may be bidirectional,” Xiang said. “The potential impact of sleep quality on asthma may have significant public health implications, contributing to the understanding of prevention of asthma risks.”
The researchers examined the records of 455,405 participants aged 38 to 73 years (mean age, 56.54 ± 8.07 years) in the UK Biobank cohort, including 17,836 diagnosed with asthma during an 8.1-year median follow-up period.
A questionnaire assessed sleep patterns based on chronotype, sleep duration, insomnia, snoring and excessive daytime sleepiness. Also, a weighted polygenic risk score (PRS) determined low, intermediate or high genetic risk for asthma.
Compared with patients with low genetic risk, patients with high genetic risk had a hazard ratio of 1.47 (95% CI, 1.41-1.52; P < .001) and patients with poor sleep patterns had a 1.55 HR (95% CI, 1.45-1.65; P < .001) for asthma.
The researchers said the effects of PRS and sleep patterns had a dose-response relationship with asthma risk, but sleep patterns and PRS had no evident interactions. Also, hazard ratios were slightly larger in women (HR = 1.5) vs. men (HR = 1.38) based on sleep patterns, the researchers continued (P = .01).
The risk for asthma increased by 122% for patients with both poor sleep patterns and high genetic risk compared with patients with healthy sleep patterns and low genetic risk (HR = 2.22; 95% CI, 1.97-2.49; P < .001).
Patients with high genetic risk and healthy sleep patterns had slightly less risk for asthma than those patients with poor sleep patterns and low genetic risk (HRs = 1.54 vs. 1.68), the researchers said, indicating that healthy sleep patterns could mitigate high genetic risk.
Healthy sleep patterns decreased risk for asthma by 44% (HR = 0.56; 95% CI, 0.5-0.64) in the group with low genetic risk, 41% (HR = 0.59; 95% CI, 0.53-0.67) in the group with intermediate genetic risk and 37% (HR = 0.63; 95% CI, 0.57-0.7) in the group with high genetic risk, suggesting that healthy sleep patterns could significantly decrease risks for asthma for patients with any genetic risk.
When the researchers collapsed the genetic risk categories into just low and high, patients with healthy sleep patterns and low genetic risk had a 25% reduced risk for asthma compared with other patients (HR = 0.76; 95% CI, 0.74-0.79; P < .001).
Each factor measured in sleep patterns was independently associated with reductions in risk for asthma, including 7 to 9 hours of sleep each day (20%), early chronotype (8%), never or rare insomnia (25%), a lack of self-reported snoring (9%) and a lack of frequent daytime sleepiness (15%).
Patients with healthy scores for each of these factors had a 22% lower risk for asthma than other patients (HR = 0.78; 95% CI, 0.74-0.83; P < .001). Population attributable risk percent (PAR%) indicated a theoretical 17.26% reduction in asthma cases for low genetic risk.
Also, the researchers said, PAR% indicated that improvements in all five factors assessed in sleep patterns could prevent 19.03% of asthma cases in the population.
“The most exciting finding for us is that sleep is strongly associated with the risk of asthma regardless of genetic susceptibility. This strong association remains under multiple scenarios. This also suggests that there may be a potential causal relationship between sleep and asthma, which, of course, requires more research to confirm,” Xiang said.
“Furthermore, genetic predisposition and poor sleep quality produce a biologic interaction, which more than doubles the probability of developing asthma,” Xiang continued. “These findings are important and valuable for identifying priority populations and for intervention decisions.”
Since healthy sleep patterns appeared to benefit asthma prevention regardless of genetic conditions, the researchers continued, early detection and management of sleep disorders might reduce asthma incidence.
“We believe these findings can be used for asthma screening and prevention. Early sleep quality interventions are expected to reduce the incidence of asthma, especially among individuals with genetic susceptibility,” Xiang said.
“Second, given the bidirectional association between poorer sleep quality and asthma, poor sleep quality may to some extent indicate the early developmental process of asthma, which could prompt diagnosis and treatment of asthma,” Xiang continued.
To improve asthma prevention, the researchers next will investigate the effect of dynamic changes in sleep quality on asthma occurrence using longitudinally observed data.
“The finding could provide evidence to support the effect of sleep interventions on reduction of asthma risks,” Xiang said.
“Besides, future research requires large observational studies or randomized controlled trials in patients with asthma. It aims to explore whether sleep interventions could improve asthma treatment in patients who already have asthma,” Xiang said.
For more information:
Bowen Xiang can be reached at 202136497@mail.sdu.edu.cn.