High likelihood for OSA, depression, poor asthma control in patients with asthma, insomnia
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Key takeaways:
- Having asthma and insomnia vs. no insomnia led to more diagnoses of obstructive sleep apnea and depression/anxiety.
- Those with insomnia also had more asthma exacerbations per year vs. those without insomnia.
WASHINGTON — More patients with asthma and insomnia had obstructive sleep apnea, depression and worse exacerbations than patients without insomnia, according to research presented at the American Thoracic Society International Conference.
“I hope these findings raise awareness among providers that patients with asthma may have poor nocturnal control, or poor disease control in general, because of their asthma but also are impacted by other underlying mood and sleep disorders,” Sarah Rhoads, MD, a second-year pulmonary sciences and critical care medicine fellow at the University of Colorado, told Healio. “I would like to see more attention paid to patients’ sleep quality, similar to the way that depression assessments have made it into the standard of care.”
In a retrospective chart review, Rhoads and colleagues assessed 89 patients with asthma and insomnia from National Jewish Health to see how the two diagnoses together influence the prevalence of simultaneous obstructive sleep apnea (OSA), depression/anxiety and poor asthma control compared with patients who only have asthma. Researchers also wanted to find areas that could be pursued to improve quality of life.
To understand how insomnia effects patients with asthma, those with both diagnoses were matched to those without insomnia according to age, sex, Charlson comorbidity index and biologic therapy (n = 89) to compare outcomes.
Researchers found a higher prevalence of OSA in patients with insomnia than in patients without insomnia (57.3% vs. 18%; P < .001). Further, depression/anxiety was found in 68.5% of patients with insomnia, whereas this diagnosis was only found in 11.4% of patients without insomnia (P < .001), according to the abstract.
“One thing that surprised us was the extent of comorbid depression or anxiety, and in particular how common a diagnosis of OSA was in individuals with insomnia and with mood disorders,” Rhoads told Healio.
In terms of asthma control, researchers observed that those with insomnia experienced a higher average rate of exacerbations per year than those without insomnia (0.93 exacerbations vs. 0.59 exacerbations; P = .039).
“Sleep quality and asthma have not been explored much, so this study points us to a variety of ways we can understand how to evaluate our patients with asthma for other disorders that may affect nocturnal symptoms and asthma control,” Rhoads told Healio.
“This was a very small study based on an existing cohort, without being able to really dive into the extent of these mood and sleep disorders,” she added. “Future studies, in addition to looking at a larger population and at nonasthmatic controls, will include assessments of insomnia severity, etc.”
For more information:
Sarah Rhoads, MD, can be reached at sarah.rhoads@cuanschutz.edu.