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Self-perceived Sleep Quality and Quantity in Adults With Asthma: Findings From the CosteAsma Study

Sanz de Burgoa V1, Rejas J2, Ojeda P3 on behalf of the investigators of the Coste Asma study

1Medical Department, Pfizer S.L.U., Alcobendas, Madrid, Spain
2Health Economics and Outcomes Research Department, Pfizer S.L.U., Alcobendas, Madrid, Spain
3Clínica de Asma y Alergia Dres. Ojeda, Madrid, Spain

J Investig Allergol Clin Immunol 2016; Vol 26(4) : 256-262
doi: 10.18176/jiaci.0044

Background and Objective: Nocturnal asthma symptoms are associated with poor sleep quality, excessive daytime sleepiness, and poor daytime functioning. The aim of this study was to describe self-perceived sleep quality and quantity in asthmatic adults in a real-world setting according to different determinants of patient health status.

Methods: A cross-sectional, observational, seasonal, multiwave survey was designed. Allergists nationwide were asked to consecutively survey adult asthmatics aged 18 to 65 years, evenly distributed by seasons and asthma severity (Global Initiative for Asthma criteria). Sleep quality and quantity were assessed using the self-administered Medical Outcomes Study (MOS) Sleep Scale. The Asthma Control Test was applied to ascertain the degree of asthma symptom control.

Results: A total of 1098 individuals (58.7% females, 41.2 [13.6] years) were analyzed. Asthma severity was associated with poor sleep quality and quantity; patients with more severe disease scored higher on the MOS Sleep Scale (P<.001) and also reported significantly fewer daily average hours of sleep (0.3-0.5 hours, P<.001). Level of symptom control and asthma severity were both associated with poor sleep quality and quantity, with the following mean MOS sleep problem index scores: 25.3 (fully controlled asthma), 26.4 (controlled), 32.6 (partly controlled), and 44.6 (uncontrolled) (P<.001), and 48.4 (severe asthma), 39.0 (moderate), 32.6 (mild), and 26.5 (intermittent) (P<.001). Sex was significantly associated with the summary MOS sleep problem index.

Conclusions: Sleep quality and quantity was significantly associated with poor health status in asthmatic patients. Guidelines should recommend asking about nocturnal asthma symptoms and encourage clinicians to take a global sleep history. Better control of nocturnal asthma symptoms could lead to improved sleep quality and a decrease in daytime sleep-related symptoms.

Key words: Asthma, Real-world setting, Sleep quality and quantity, MOS sleep scale, Disability.