Asthma, allergies more common in adolescents who sleep late

Adolescent circadian preference may be associated with the development of asthma and allergies, according to data published in ERJ Open Research.

“Adolescents who sleep late are more prone to have asthma and allergic diseases than those who are early sleepers,” Subhabrata Moitra, PhD, AMRSPH, from the division of pulmonary medicine at the University of Alberta, Canada, told Healio. “Clinicians should be vigilant in asking questions about sleep, diet, habit, physical activities, etc, while treating their patients. It could be quite possible that lifestyle modification could better help managing these chronic diseases.”

Researchers analyzed data from the Prevalence and Risk Factors of Asthma and Allergy-Related Diseases Among Adolescents (PERFORMANCE) study on 1,684 adolescents living in West Bengal, India (aged 13-14 years; 42% girls). Participants were administered an International Study of Asthma and Allergy in Childhood phase 3 questionnaire to obtain information about respiratory symptoms and a Morningness-Eveningness Questionnaire to obtain information about circadian preference. The researchers compared the adolescents’ respiratory symptoms with sleep preference and also analyzed factors such as sex, residence area, parental atopy/asthma, smoke exposure, pet exposure and number of siblings.

Forty-two percent of participants were identified as “morning types,” 9% were “evening types” and the remainder as “intermediate types.”

Thirteen percent of participants reported a history of wheezing, 21% a history of rhinitis and 11% a history asthma. Current wheeze, defined as symptoms in the previous year, was present in 7%, current rhinitis in 17% and current rhinoconjunctivitis in 9%,

Compared with morning-type adolescents, evening-type adolescents had a higher risk for current wheeze (6.4% vs. 11.7%; RR = 1.85; 95% CI, 1.02-3.35). Rhinoconjunctivitis was higher in intermediate-type adolescents (RR = 1.51; 95% CI, 1.02-2.23) and evening-type adolescents (RR = 2.76; 95% CI, 1.94-3.92) compared with morning types. Risk for asthma was three times higher among evening-type adolescents compared with morning-type adolescents (23.6% vs. 6.2%; RR = 2.67; 95% CI, 1.65-4.31).

The researchers reported that the association between chronotype and respiratory symptoms did not differ after stratification by sex and there was no evidence for effect modification by parental atopy/asthma, smoke exposure at home, pet exposure and number of siblings.

“We need many more clinical and epidemiological studies across different countries. Demography and culture are likely to vary across countries, therefore, more extensive studies are required,” Moitra said. “Circadian pattern is well known to be associated with several diseases, but very little known about its association with asthma and allergies. Therefore, we need to look into the molecular mechanism as well to disentangle the relationship.”

A second phase of the PERFORMANCE study is scheduled to be conducted in 2028 to 2029, according to a press release. This second phase will determine whether there are any changes in sleeping habits and respiratory health in a new group of adolescents. Moitra and colleagues aim to quantify their findings by taking objective measurements of participants’ lung function and sleep time, according to the release.

“Apart from the classical risk factors such as air pollution, smoking, obesity and genetic factors, there could be several undetermined social, interpersonal and behavioral factors that could also be associated with these diseases,” Moitra said.

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Subhabrata Moitra, PhD, AMRSPH, can be reached at moitra@ualberta.ca.