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Liu Q, Shan Q, Rehman ZU. Sex- and age-dependent associations of EPA and DHA with very short sleep duration in adults: a cross-sectional analysis. Nutr Neurosci 2024; 27:1113-1122. [PMID: 38335043 DOI: 10.1080/1028415x.2024.2303217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
OBJECTIVES This study aimed to compare the efficacy of dietary intake of eicosapentaenoic acid (EPA; 20:5 ω-3) and docosahexaenoic acid (DHA; 22:6 ω-3) on very short sleep duration (<5 h/night) in adults. METHODS The bootstrap method was used in the multinomial logistic regression to estimate the ORs and corresponding 95% confidence intervals (CIs) of very short sleep duration. We used rolling window method to analyze the effects of EPA and DHA dietary intakes on very short sleep durations in men and women over age. To illustrate the stability of the results for the selected window width, we built a shiny application. RESULTS Compared to the first quartile, the mean ORs of EPA intake on very short sleep duration and the corresponding 95% CIs for the second, third and fourth quartiles of EPA intake among men under 32 years old were 1.50 (0.56, 3.44) mg, 1.55 (0.59, 3.48) mg, and 3.99 (1.15, 10.01) mg, respectively. Among women over 44 years old, the ORs for DHA intake were 1.12 (0.81, 1.52) mg, 0.94 (0.68, 1.29) mg, and 0.62 (0.38, 0.98) mg for the second, third and fourth quartiles, respectively. CONCLUSIONS The associations of EPA and DHA with very short sleep duration are sex- and age-dependent. In males under the age of 32, a significant positive correlation exists between dietary EPA intake and very short sleep duration. For women above 44 years of age, an increase in DHA intake can notably ameliorate issues of very short sleep duration.
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Affiliation(s)
- Qianning Liu
- Department of Statistics, Jiangxi University of Finance and Economics, Nanchang, People's Republic of China
| | - Qingsong Shan
- Department of Statistics, Jiangxi University of Finance and Economics, Nanchang, People's Republic of China
| | - Zahid Ur Rehman
- Department of Statistics, Jiangxi University of Finance and Economics, Nanchang, People's Republic of China
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2
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Ascher K, Shafazand S. Dyspnea and Quality of Life Improvements with Management of Comorbid Obstructive Sleep Apnea in Chronic Lung Disease. Sleep Med Clin 2024; 19:371-378. [PMID: 38692759 DOI: 10.1016/j.jsmc.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Obstructive sleep apnea (OSA) has emerged as a significant and prevalent comorbidity associated with chronic lung diseases, including chronic obstructive pulmonary disease, asthma, and interstitial lung diseases. These overlap syndromes are associated with worse patient-reported outcomes (sleep quality, quality of life measures, mental health) than each condition independently. Observational studies suggest that patients with overlap syndrome who are adherent to positive airway pressure therapy report improved quality of life, sleep quality, depression, and daytime symptoms. Screening for and management of OSA in patients with overlap syndrome should emphasize the interconnected nature of these 2 conditions and the positive impact that OSA management can have on patients' well-being and overall health.
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Affiliation(s)
- Kori Ascher
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami, Miller School of Medicine
| | - Shirin Shafazand
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami, Miller School of Medicine.
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Souza MR, Rosa DS, Alvarenga TA, Morelhão PK, Tufik S, Andersen ML. Do nocturnal asthma attacks influence sleep parameters and inflammatory markers? A cross-sectional population-based study. Sleep Breath 2024; 28:619-627. [PMID: 37833518 DOI: 10.1007/s11325-023-02935-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
PURPOSE To evaluate the effects of nocturnal asthma on sleep parameters and inflammatory markers according to the severity of the condition in participants in the São Paulo Epidemiologic Sleep Study (EPISONO). METHODS Data from the 2007 and 2018 editions of the EPISONO study were utilized. Subjects completed validated sleep and respiratory questionnaires, underwent nocturnal polysomnography and spirometry tests, and provided blood samples for the assessment of inflammatory parameters. RESULTS Of 72 participants (67% women), 53% (n = 38) had intermittent nocturnal asthma symptoms and 47% (n = 34) had persistent asthma (mild, moderate, and severe). Individuals with persistent nocturnal symptoms had a higher body mass index (BMI), were more likely to have respiratory symptoms, and had worse lung function, a higher apnea-hypopnea index (AHI), and higher desaturation index than individuals with intermittent nocturnal symptoms. Positive associations were identified between nocturnal asthma and obstructive sleep apnea (OSA). A higher frequency of OSA was observed in participants with persistent asthma and participants with OSA were more likely to have persistent than intermittent asthma. However, there were no significant differences between the immunological parameters of those with intermittent or persistent asthma. CONCLUSIONS This study highlights the relevance of nocturnal symptoms as a valuable indicator of asthma severity. The findings also add to the existing body of evidence linking nocturnal asthma and OSA.
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Affiliation(s)
| | - Daniela Santoro Rosa
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Priscila K Morelhão
- Sleep Institute, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, SP, 04024-002, Brazil
| | - Sergio Tufik
- Sleep Institute, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, SP, 04024-002, Brazil
| | - Monica L Andersen
- Sleep Institute, São Paulo, Brazil.
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, SP, 04024-002, Brazil.
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4
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Al Meslamani AZ. How does sleep influence asthma through immunity? Expert Rev Clin Immunol 2024; 20:323-326. [PMID: 37962951 DOI: 10.1080/1744666x.2023.2284213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/13/2023] [Indexed: 11/16/2023]
Affiliation(s)
- Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
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Sharma V, Ricketts HC, Steffensen F, Goodfellow A, Buchan DS, Cowan DC. Accelerometer-derived sleep metrics in mild and difficult-to-treat asthma. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:5. [PMID: 38221641 PMCID: PMC10787977 DOI: 10.1186/s13223-024-00874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Poor sleep health is associated with increased asthma morbidity and mortality. Accelerometers have been validated to assess sleep parameters though studies using this method in patients with asthma are sparse and none have compared mild to difficult-to-treat asthma populations. METHODS We performed a retrospective analysis from two recent in-house trials comparing sleep metrics between patients with mild and difficult-to-treat asthma. Participants wore accelerometers for 24-hours/day for seven days. RESULTS Of 124 participants (44 mild, 80 difficult-to-treat), no between-group differences were observed in sleep-window, sleep-time, sleep efficiency or wake time. Sleep-onset time was ~ 40 min later in the difficult-to-treat group (p = 0.019). DISCUSSION Broadly, we observed no difference in accelerometer-derived sleep-metrics between mild and difficult-to-treat asthma. This is the largest analysis of accelerometer-derived sleep parameters in asthma and the first comparing groups by asthma severity. Sleep-onset initiation may be delayed in difficult-to-treat asthma but a dedicated study is needed to confirm.
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Affiliation(s)
- Varun Sharma
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
- Glasgow Royal Infirmary, Clinical Research Facility, Glasgow, UK.
- Respiratory Department, Glasgow Royal Infirmary, 84 Castle Street, Walton Building, Fourth Floor, Glasgow, G4 0SF, UK.
| | - Helen Clare Ricketts
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- Glasgow Royal Infirmary, Clinical Research Facility, Glasgow, UK
| | - Femke Steffensen
- Glasgow Royal Infirmary, Clinical Research Facility, Glasgow, UK
| | - Anna Goodfellow
- Glasgow Royal Infirmary, Clinical Research Facility, Glasgow, UK
| | - Duncan S Buchan
- Division of Sport and Exercise, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | - Douglas C Cowan
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- Glasgow Royal Infirmary, Clinical Research Facility, Glasgow, UK
- Respiratory Department, Glasgow Royal Infirmary, 84 Castle Street, Walton Building, Fourth Floor, Glasgow, G4 0SF, UK
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Poluektov MG, Akarachkova ES, Dovgan EV, Kotova OV, Demidova TY, Klimenko AA, Kokorin VA, Ostroumova OD, Ostroumova TM. [Management of patients with insomnia and polymorbidity. A draft of the clinical guidelines]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:39-52. [PMID: 38934665 DOI: 10.17116/jnevro202412405239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Insomnia is a serious and widespread public health problem, but is often undetected and patients do not receive needed treatment. Insomnia is often comorbid with other diseases and conditions, such as arterial hypertension, type 2 diabetes mellitus, pain syndromes, anxiety and depressive disorders, etc. A separate problem is drug-induced insomnia, when patients develop symptoms due to other diseases treatments. Insomnia has a negative effect on the prognosis of comorbid diseases, including an increased risk of death, more severe disease, and decreased quality of life. The presence of sleep disorders makes it difficult to effectively treat the underlying disease, so clinical guidelines draft for the evaluation and treatment of insomnia in multimorbid patients is proposed. Diagnostic methods are reviewed and recommendations are given for the treatment of acute and chronic insomnia and features of the treatment of insomnia in multimorbid patients. A clinical algorithm has been proposed to determine treatment tactics in multimorbid patients.
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Affiliation(s)
- M G Poluektov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - E S Akarachkova
- LLC International society «Stress under control», Moscow, Russia
| | - E V Dovgan
- Smolensk Regional Clinical Hospital, Smolensk, Russia
| | - O V Kotova
- LLC International society «Stress under control», Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
| | - T Yu Demidova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Klimenko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - V A Kokorin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - O D Ostroumova
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - T M Ostroumova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Zhao Y, Cheng X, Song C. Joint associations of asthma and sleep duration with cardiovascular disease and all-cause mortality: a prospective cohort study. Ann Epidemiol 2023; 88:1-6. [PMID: 37865213 DOI: 10.1016/j.annepidem.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE This study aimed to investigate the joint association of asthma and sleep duration with cardiovascular disease (CVD) and mortality risk. METHODS This prospective cohort study included 366,387 participants from the UK Biobank. The participants were divided into three groups based on their sleep duration (short: <7 h/d; referent: 65+ years: 7-8 h/d; ages 39-64 years: 7-9 h/d; and long: 65+ years: >8 h/d; ages 39-64 years: >9 h/d). Cox proportional hazards models were used to examine the association between asthma and sleep duration on CVD and all-cause mortality. RESULTS Participants with asthma and short sleep duration showed increased risk of CVD (hazard ratio [HR] 1.42; 95% confidence interval [CI] 1.34-1.51) and all-cause mortality (HR, 1.26; 95% CI, 1.17-1.36), compared with participants with no asthma in the referent sleep duration group. We documented significant additive interactions between asthma and short sleep duration in relation to CVD (relative excess risk due to interaction [RERI], 0.13; 95% CI, 0.04-0.23) and all-cause mortality (RERI, 0.12; 95% CI, 0.01-0.23). CONCLUSIONS Asthma and short sleep duration may have additive interactions on CVD and all-cause mortality risk, highlighting the importance of controlling asthma in combination with improving sleep duration.
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Affiliation(s)
- Yuhao Zhao
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chao Song
- Nosocomial Infection Control Center, Xiangya Hospital, Central South University, Changsha, Hunan, China; Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China.
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8
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Wang CY, Wang J, Zhang L, Zhang SW, Wang L, Zhao SZ, Chen ZH, Zhang X, Xie M, Wang T, Chen-Yu Hsu A, Qin L, Oliver BG, Liu L, Wan HJ, Liu D, Luo FM, Li WM, Wang G. Self-Reported Insufficient Sleep Is Associated With Clinical and Inflammatory Features of Asthma: A Prospective Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1200-1210.e4. [PMID: 36581067 DOI: 10.1016/j.jaip.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/14/2022] [Accepted: 12/06/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND A few studies have explored the association between short sleep duration and worse asthma outcomes in patients with self-reported asthma; however, all of them were cross-sectional. OBJECTIVES To investigate the association between self-reported sleep duration and asthma-related clinical and inflammatory characteristics and whether sleep duration is associated with asthma exacerbations (AEs) in the following year. METHODS A prospective cohort study consecutively recruited participants with asthma, who were classified into short (n = 58), normal (n = 380), and long (n = 84) sleep duration groups. We investigated the clinical and inflammatory characteristics and exacerbations within a 1-year follow-up. RESULTS Patients with short sleep duration were older and had significantly lower total IgE and FeNO levels and higher airway inflammation, characterized by increased levels of IL-6 and TNF-α in sputum than those of patients with normal sleep duration. Furthermore, they had a significantly increased risk for poorly controlled asthma (adjusted odds ratio = 2.741; 95% CI, 1.379-5.447; P = .004) and moderate to severe AEs (adjusted incidence rate ratio = 1.798; 95% CI, 1.098-2.942; P = .020). CONCLUSIONS Short sleep duration was associated with non-type 2 inflammation and is an independent risk factor for future AEs. Therefore, as a potentially treatable trait, sleep duration may have clinical implications for asthma management.
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Affiliation(s)
- Chang Yong Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China
| | - Ji Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China
| | - Li Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu Wen Zhang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Wang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu Zhen Zhao
- Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi Hong Chen
- Shanghai Institute of Respiratory Disease, Respiratory Division of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xin Zhang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Xie
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Lin Qin
- Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Brian G Oliver
- School of Life Sciences, University of Technology Sydney, Ultimo, New South Wales, Australia; Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Lei Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hua Jing Wan
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China
| | - Feng Ming Luo
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China
| | - Wei Min Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China.
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China.
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Sher LD, Passalacqua G, Taillé C, Cohn L, Daizadeh N, Pandit-Abid N, Soler X, Khodzhayev A, Jacob-Nara JA, Deniz Y, Rowe PJ, Nag A, Zhang Y. The long-term effect of dupilumab on dyspnea, sleep, and activity in oral corticosteroid-dependent severe asthma. Ann Allergy Asthma Immunol 2023; 130:298-304. [PMID: 36509407 DOI: 10.1016/j.anai.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Severe asthma impacts quality of life (QoL), including dyspnea, sleep, and activity limitation. Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukins-4 and -13, which are key and central drivers of type 2 inflammation. Phase 3 LIBERTY ASTHMA VENTURE (NCT02528214) and LIBERTY ASTHMA TRAVERSE open-label extension (NCT02134028) evaluated dupilumab 300 mg vs placebo every 2 weeks for 24 weeks (VENTURE) and dupilumab only for an additional 48 to 96 weeks (TRAVERSE) in patients with oral corticosteroid (OCS)-dependent severe asthma. OBJECTIVE To assess dupilumab's impact on Asthma QoL Questionnaire (AQLQ) items related to breathing symptoms, sleep, and activity limitation, and on OCS reduction. METHODS The proportion of patients with AQLQ scores of 6 or 7 for breathing symptoms-, sleeping-, and activity-related items in VENTURE and TRAVERSE, together with OCS dose reductions in VENTURE. RESULTS In VENTURE, significantly greater proportions of dupilumab- vs placebo-treated patients achieved scores of 6 or 7 by week 24 in breathing symptoms-related (42.7%-60.2% vs 22.4%-39.3%), sleeping-related (45.6%-65.0% vs 27.1%-47.7%), and activity-related (44.7%-51.5% vs 22.4%-34.6%) AQLQ items. Improvements were maintained through TRAVERSE in the dupilumab/dupilumab group and increased to dupilumab treatment levels in the placebo/dupilumab group. Significant OCS dose reductions were observed in VENTURE; up to 90% and 60% of dupilumab-treated vs 65% and 41% of placebo-treated patients with AQLQ scores of 6 or 7 in breathing symptoms-, sleeping-, and activity-related items achieved greater than or equal to 50% dose reduction and eliminated OCS at week 24, respectively. CONCLUSION In patients with severe OCS-dependent asthma, dupilumab improved QoL related to breathing symptoms, sleep, and activity limitation, and reduced OCS use. TRIAL REGISTRATION ClinicalTrials.gov Identifiers: NCT02528214 and NCT02134028.
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Affiliation(s)
- Lawrence D Sher
- Peninsula Research Associates, Rolling Hills Estates, Los Angeles, California.
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Martino, University of Genoa, Genoa, Italy
| | - Camille Taillé
- Service de Pneumologie et Centre de Référence des Maladies Pulmonaires Rares, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Lauren Cohn
- Yale Center for Asthma and Airway Diseases, Yale School of Medicine, New Haven, Connecticut; Veteran Affairs Connecticut Health Care System, West Haven, Connecticut
| | | | | | - Xavier Soler
- Medical Affairs, Regeneron Pharmaceuticals, Incorporated, Tarrytown, New York
| | - Angela Khodzhayev
- Medical Affairs, Regeneron Pharmaceuticals, Incorporated, Tarrytown, New York
| | | | - Yamo Deniz
- Medical Affairs, Regeneron Pharmaceuticals, Incorporated, Tarrytown, New York
| | | | - Arpita Nag
- Immunology, Sanofi, Cambridge, Massachusetts
| | - Yi Zhang
- Medical Affairs, Regeneron Pharmaceuticals, Incorporated, Tarrytown, New York
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10
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Ruan Z, Li D, Cheng X, Jin M, liu Y, Qiu Z, Chen X. The association between sleep duration, respiratory symptoms, asthma, and COPD in adults. Front Med (Lausanne) 2023; 10:1108663. [PMID: 37138746 PMCID: PMC10150117 DOI: 10.3389/fmed.2023.1108663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction The association between sleep duration and cough, wheezing, and dyspnea was unclear. This research aimed to test this relationship. Methods Research data were obtained from people who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2012. We used weighted logistic regression analysis and fitted curves to explore the association between sleep and respiratory symptoms. In addition, we investigated the association between sleep duration, chronic obstructive pulmonary disease (COPD), and asthma. The stratified analysis is used to analyze inflection points and specific populations. Results The 14,742 subjects are weighted to reflect the 45,678,491 population across the United States. Weighted logistic regression and fitted curves show a U-shaped relationship between sleep duration and cough and dyspnea. This U-shaped relationship remained in people without COPD and asthma. The stratified analysis confirmed that sleep duration before 7.5 h was negatively associated with cough (HR 0.80, 95% CI 0.73-0.87) and dyspnea (HR 0.82, 95% CI 0.77-0.88). In contrast, it was positively associated with cough and (HR 1.30, 95% CI 1.14-1.48) dyspnea (HR 1.12, 95% CI 1.00-1.26) when sleep duration was >7.5 h. In addition, short sleep duration is associated with wheezing, asthma, and COPD. Conclusion Both long and short sleep duration are associated with cough and dyspnea. And short sleep duration is also an independent risk factor for wheezing, asthma, and COPD. This finding provides new insights into the management of respiratory symptoms and diseases.
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Affiliation(s)
- Zhishen Ruan
- The First Clinical College, Shandong Chinese Medical University, Jinan, China
| | - Dan Li
- The First Clinical College, Shandong Chinese Medical University, Jinan, China
| | - Xiaomeng Cheng
- College of Traditional Chinese Medicine, Shandong Chinese Medical University, Jinan, China
| | - Minyan Jin
- The First Clinical College, Shandong Chinese Medical University, Jinan, China
| | - Ying liu
- College of Traditional Chinese Medicine, Shandong Chinese Medical University, Jinan, China
| | - Zhanjun Qiu
- The First Clinical College, Shandong Chinese Medical University, Jinan, China
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- *Correspondence: Zhanjun Qiu,
| | - Xianhai Chen
- The First Clinical College, Shandong Chinese Medical University, Jinan, China
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- Xianhai Chen,
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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Li J, Guo L. Association between sleep duration and albumin in US adults: a cross-sectional study of NHANES 2015-2018. BMC Public Health 2022; 22:1102. [PMID: 35655296 PMCID: PMC9161202 DOI: 10.1186/s12889-022-13524-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Albumin has multiple functions and is used in the clinical assessment of liver function, kidney function and nutritional status. However, few epidemiological studies have evaluated the association between sleep duration and albumin. Therefore, we carried out a cross-sectional study to address this issue. The aim of the study was to investigate the association between sleep duration and albumin in American adults based on the NHANES (National Health and Nutrition Examination Survey). METHODS A total of 9,973 participants aged [Formula: see text] 20 years were included in this study from NHANES 2015-2018. Weighted data were calculated according to analytical guidelines. Linear regression models and smooth curve fitting were used to assess and describe the relationship between sleep duration and albumin. The inflection point was determined by a two-step recursive method. Moreover, univariate and stratified analyses were performed. RESULTS There was an inverted U-shaped association between sleep duration and albumin levels. Albumin levels were highest when the sleep duration was 7.5 h. Compared to 7-8 h of sleep, short sleep duration was linked to lower albumin levels [sleep duration [Formula: see text] 5 h: β [Formula: see text]-1.00, 95% CI (-1.26, -0.74), P < 0.0001]. Compared to 7-8 h of sleep, long sleep duration was related to lower albumin levels [sleep duration [Formula: see text] 9 h: β [Formula: see text] -0.48, 95% CI (-0.68, -0.27), P < 0.0001]. CONCLUSIONS Sleep duration had an inverted U-shaped relationship with albumin, with short or long sleep duration associated with significantly lower albumin levels.
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Affiliation(s)
- Jingxian Li
- Nanjing University of Chinese Medicine, Nanjing, 210029, China.
- Jining NO.1 People's Hospital, Jining, 272000, China.
| | - Lizhong Guo
- Nanjing University of Chinese Medicine, Nanjing, 210029, China
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13
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Allergy-related outcomes and sleep-related disorders in adults: a cross-sectional study based on NHANES 2005-2006. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2022; 18:27. [PMID: 35317862 PMCID: PMC8941730 DOI: 10.1186/s13223-022-00669-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022]
Abstract
Background Epidemiological evidence between the sleep disorders and allergy-related outcomes is limited. Objectives The purpose of the present study was to estimate the relationship between sleep disorders and allergy-related outcomes in adults. Methods We built logistic regression models to examine the associations between sleep disorders and allergy-related outcomes in adult participants using the 2005–2006 NHANES database. Allergy-related outcomes included sIgE levels, asthma, hay fever, sneezing, wheezing, and eczema. Sleep disorders included sleep latency, sleep length, sleep problems, OSA symptoms, and daytime sleepiness. A t-test was used for between-group comparisons. Results Participants with OSA symptoms had 2.72 × higher odds of experiencing hay fever and 1.54 × higher odds of having eczema compared to Non-OSA symptoms participants. Participants with insufficient sleep (≤ 6 h/night) had 1.27 × higher odds of developing allergic sensitisation compared to participants with adequate sleep (7–8 h/night). Sneezing was positively associated with sleep problems (OR: 1.706; 95% CI 1.386, 2.099), OSA symptoms (OR: 1.297; 95% CI 1.049, 1.605), and daytime sleepiness (OR: 1.569; 95% CI 1.205, 2.04). Conclusion Our findings suggest a positive association between allergy-related outcomes and sleep disorders. In particular, OSA symptoms, daytime sleepiness, and sleep problems are strongly associated with allergic conditions. Graphical Abstract ![]()
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Baniak LM, Scott PW, Chasens ER, Imes CC, Jeon B, Shi X, Strollo PJ, Luyster FS. Sleep problems and associations with cardiovascular disease and all-cause mortality in asthma-COPD overlap: analysis of the National Health and Nutrition Examination Survey (2007-2012). J Clin Sleep Med 2022; 18:1491-1501. [PMID: 35040430 DOI: 10.5664/jcsm.9890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The impact of sleep problems (i.e. sleep duration and presence of sleep disorders) on cardiovascular morbidity and all-cause mortality in adults with asthma-COPD overlap (ACO) is unknown. METHODS Using the National Health and Nutrition Examination Survey (NHANES) database (2007-2012 cycles) and National Death Index data, we identified 398 persons with ACO. Data on self-reported physician-diagnosed sleep disorder and cardiovascular disease were collected. Sleep duration in hours was categorized as short (≤5), normal (6-8), and long (≥9). Associations between sleep duration and presence of sleep disorders and cardiovascular disease and all-cause mortality were analyzed in regression models adjusted for age, sex, race, smoking status, and body mass index. RESULTS Presence of sleep disorders was more commonly reported in the ACO group (24.7%) compared to all other groups. The ACO group had a higher proportion of short sleepers (27.6%) compared to controls (11.7%) and COPD (19.2%) and a higher proportion of long sleepers (6.9%) compared to COPD (5.5%). Presence of sleep disorders was associated with increased risk for CVD (OR = 2.48, 95% CI, 1.65 - 3.73) and death (HR = 1.44, 95% CI, 1.03 - 2.02); risk did not vary between groups. A stronger association existed between sleep duration and increased risk for CVD and all-cause mortality in ACO as compared to COPD and controls. CONCLUSIONS These results suggest that persons with ACO may represent a high-risk group that should be targeted for more aggressive intervention of sleep problems, a modifiable risk factor.
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Affiliation(s)
- Lynn M Baniak
- Veteran Affairs Pittsburgh Healthcare System, Pittsburgh PA.,School of Nursing, University of Pittsburgh, Pittsburgh PA
| | - Paul W Scott
- School of Nursing, University of Pittsburgh, Pittsburgh PA
| | | | | | - Bomin Jeon
- School of Nursing, University of Pittsburgh, Pittsburgh PA
| | - Xiaojun Shi
- School of Nursing, University of Pittsburgh, Pittsburgh PA
| | - Patrick J Strollo
- Veteran Affairs Pittsburgh Healthcare System, Pittsburgh PA.,School of Medicine, University of Pittsburgh, Pittsburgh PA
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Hu Z, Song X, Hu K. The Effect of Short Sleep Duration on the Development of Asthma. Int J Clin Pract 2022; 2022:3378821. [PMID: 35685599 PMCID: PMC9159162 DOI: 10.1155/2022/3378821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/20/2022] [Accepted: 05/02/2022] [Indexed: 11/29/2022] Open
Abstract
Asthma is regarded as a heterogeneous disease with chronic airway inflammation and reversible airway limitation. Asthma itself and recurrent attacks of asthma can decrease sleep duration and increase the prevalence of short sleep duration. Systemic low-grade inflammation and obesity caused by short sleep duration have been known for a long time, which potentially affect the development of asthma. It would be interesting to study the interaction between short sleep duration and asthma. However, there are relatively few studies and no review about the association between short sleep duration and asthma. This article performed a review about the relationships between short sleep duration and asthmatic phenotype, laboratory tests, comorbidity, and clinical outcomes. Pooled studies about short sleep duration and asthma provided following four results: (1) compared with healthy sleep duration, short sleep duration seemingly increased the risk of central obesity in asthmatics; (2) short sleep duration potentially reduced the level of FeNO and increased lung function impairment in patients with asthma; (3) asthmatic comorbidities, mainly obesity and depression, were negatively associated with short sleep duration among asthmatics; (4) short sleep duration potentially increased the risks of asthma-related hospitalization and emergency care. However, almost all studies are based on subjective but not objective sleep duration. In addition, the study on sleep duration and cause-specific mortality in patients with asthma is relatively scant. Considering the effect of short sleep duration on the development of asthma, we recommend that periodic sleep monitoring for asthmatic management is very necessary.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang 443003, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital at Zhijiang, Zhijiang 443003, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang 443003, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang 443003, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang 443003, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
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Mc Carthy CE. Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person. Med Sci (Basel) 2021; 9:medsci9020031. [PMID: 34063838 PMCID: PMC8162526 DOI: 10.3390/medsci9020031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson's disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.
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Affiliation(s)
- Christine E. Mc Carthy
- Department of Geriatric Medicine, University Hospital Galway, Galway, Ireland;
- HRB-Clinical Research Facility, National University of Ireland, Galway, Co., Galway, Ireland
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