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Fan Z, Xu M, Chen S, Wang J, Gong Y, Feng X, Yin X. Association of Socioeconomic Status and a Broad Combination of Lifestyle Factors With Adult-Onset Asthma: A Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2066-2073. [PMID: 38631523 DOI: 10.1016/j.jaip.2024.04.009] [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: 08/28/2023] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The prevalence of asthma is gradually increasing worldwide, and there are socioeconomic inequalities in the risk of developing asthma. OBJECTIVE To evaluate whether the lifestyle is associated with asthma in adults, as well as whether and to what extent healthy lifestyles may modify socioeconomic status (SES) inequities in asthma. METHODS This study included a total of 223,951 participants from the UK Biobank. Smoking, physical activity, alcohol consumption, healthy diet patterns, sedentary time, and sleep duration items were used to construct the lifestyle score. Income, education, and occupation were used to assess SES. Cases of adult-onset asthma were identified on the basis of electronic health records. The Cox proportional hazards regression was used to explore the association of socioeconomic inequality and lifestyle factors with asthma. RESULTS Compared with the most healthy lifestyle category, the hazard ratios (95% CIs) of the moderately healthy lifestyle and least healthy lifestyle categories for asthma were 1.08 (1.01-1.15) and 1.29 (1.20-1.39), respectively. A significant interaction (Pinteraction < .05) was found between lifestyle categories and SES, and the association between them was more pronounced in participants with low SES (hazard ratioleast healthy vs most healthy, 1.58; 95% CI, 1.40-1.80). The joint analysis revealed that the risk of asthma was highest among participants with the lowest SES and the least healthy lifestyles (hazard ratio, 2.02; 95% CI, 1.74-2.33). CONCLUSIONS Unhealthy lifestyle factors are associated with an increased risk of asthma in adults, and socioeconomically disadvantaged groups are more negatively affected by unhealthy lifestyles. Public health strategies for asthma prevention may need to be tailored according to SES, and social policies to reduce poverty are needed alongside lifestyle interventions in areas of deprivation.
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Affiliation(s)
- Zina Fan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Minzhi Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shanquan Chen
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinglin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Waddell JT, Sasser J. Too Tired to Think: Within and Between-Person Relations Among Impulsive Traits, Sleep Duration, and Mental Health Outcomes. Int J Ment Health Addict 2024; 22:703-721. [PMID: 38414721 PMCID: PMC10896226 DOI: 10.1007/s11469-022-00899-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/29/2022] Open
Abstract
Heavier drinking and depression are common mental health concerns in the USA, yet few studies have sought to understand transdiagnostic risk factors for both. Two health-focused risk factors are impulsive personality traits and sleep duration, but research typically separates the two, precluding additive and interactive relations. The current study sought to test a theoretical model where risk conferred from impulsive traits is heightened when individuals have reduced sleep. Public-access data from the National Longitudinal Study on Adolescent to Adult Health (Add Health) were used to test study hypotheses. Participants reported on impulsive traits (i.e., lack of premeditation, sensation seeking), sleep duration, depression, and drinking across three waves spanning adolescence, emerging adulthood, and adulthood. Multilevel models distinguished risk processes at the between- vs. within-person level. At the between-person level, sensation seeking predicted drinking whereas premeditation predicted depression. Additionally, within-person deviations in both traits were associated with drinking, whereas within-person deviations in premeditation were associated with depression. Sleep duration was protective against outcomes at both levels. However, main effects were qualified by interactions at both levels, such that having below average sleep duration heightened the effects of premeditation at the between-person level, whereas within-person decreases in sleep heightened the effects of sensation seeking at the within-person level. Findings support a theoretical model where poor sleep exacerbates risk conferred from impulsive traits. Risk conferred from impulsive traits diverged based upon level of analysis, suggesting that global and just-in-time interventions may benefit from targeting specific impulsive traits as well as sleep.
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Affiliation(s)
- Jack T. Waddell
- Department of Psychology, Arizona State University, 900 S McAllister, Tempe, AZ 85287-1104, USA
| | - Jeri Sasser
- Department of Psychology, Arizona State University, 900 S McAllister, Tempe, AZ 85287-1104, USA
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Chang CS, Chang LY, Wu CC, Chang HY. Associations between social jetlag trajectories and body mass index among young adults. Sleep 2024; 47:zsad270. [PMID: 37855456 DOI: 10.1093/sleep/zsad270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/11/2023] [Indexed: 10/20/2023] Open
Abstract
STUDY OBJECTIVES This study employed longitudinal data collected repeatedly from individuals over the course of several years to examine the trajectories of social jetlag from ages 11 to 22 years and their associations with subsequent body mass index (BMI). Potential sex differences were also investigated. METHODS Data were obtained from two longitudinal studies conducted in Taiwan (N = 4287). Social jetlag was defined as ≥ 2 hours of absolute difference in sleep midpoint between weekdays and weekends. BMI was calculated using weight (kg)/height(m)2 and categorized as underweight (<18 kg/m2), normal weight (18 kg/m2 ≤ BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 27 kg/m2), and obese (≥27 kg/m2). Group-based trajectory modeling and multinomial logistic regression were applied to investigate study objectives. RESULTS Four distinct trajectories of social jetlag throughout the adolescent years were identified, with corresponding proportions as follows: low-stable (42%), moderate-decreasing (19%), low-increasing (22%), and chronic (17%) trajectories. Among males, the risk of being underweight (aOR, 1.96; 95% CI: 1.35 to 2.84) or obese (aOR, 1.40; 95% CI: 1.02 to 1.92) was higher in individuals with a low-increasing trajectory than in those with a low-stable trajectory. Among females, those with a low-increasing (aOR, 1.61; 95% CI: 1.02 to 2.54) or chronic (aOR, 2.04; 95% CI: 1.27 to 3.25) trajectory were at a higher risk of being obese relative to those with a low-stable trajectory. CONCLUSIONS Addressing the development of increasing or chronic social jetlag during adolescence can help prevent abnormal BMI in young adulthood. Practitioners should consider sex differences in treatment or consultation.
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Affiliation(s)
- Chia-Shuan Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chi-Chen Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
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Liu X, Hong C, Liu Z, Fan L, Yin M, Chen Y, Ren X, Gu X. Association of sleep disorders with asthma: a meta-analysis. BMJ Open Respir Res 2023; 10:e001661. [PMID: 37735102 PMCID: PMC10514641 DOI: 10.1136/bmjresp-2023-001661] [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: 02/15/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Animal experiments and clinical trials have revealed a potential relationship between sleep disorders and asthma. However, the associations between these factors remain unclear. MATERIAL AND METHODS We searched PubMed, Embase, Web of Science and Cochrane Library databases for eligible studies published before 30 December 2022. Studies investigating the association between sleep disorders (insomnia, poor sleep quality and insufficient sleep time) and asthma were selected. Sleep disorders were assessed using questionnaires, interviews, or medical records. Asthma was diagnosed based on medical history and drug use. The Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist were employed for quality assessment. We used OR with 95% CI as the effect measures and forest plots to display the results. Heterogeneity was evaluated using I2 statistics and subgroup analyses were performed for bias analysis. Publication bias was evaluated using the funnel plots and Egger's test. RESULTS Twenty-three studies were included in the primary analysis, which suggested a positive association between sleep disorders and asthma (OR: 1.38, 95% CI 1.10 to 1.74). Subgroup analyses were conducted according to the study design, age, family history of asthma and type of sleep disorders. We did not find any association between sleep disorders and asthma in children aged ˂12 years (OR: 1.13, 95% CI 0.97 to 1.32). The association was insignificant in studies where the family history of asthma was adjusted for (OR: 1.16, 95% CI 0.94 to 1.42). Funnel plot and Egger's test indicated a significant publication bias. CONCLUSION Sleep disorders are associated with an increased prevalence and incidence of asthma. However, the quality of the evidence was low because of potential biases. PROSPERO REGISTRATION NUMBER CRD42023391989.
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Affiliation(s)
- Xueqian Liu
- Emergency Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Cheng Hong
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Zhiyu Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lihua Fan
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Moqing Yin
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Yunhu Chen
- Cardiovascular Medicine Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Xiang Ren
- Emergency Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
| | - Xuefang Gu
- Outpatient Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, Jiangsu, China
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Xiang B, Hu M, Yu H, Zhang Y, Wang Q, Xue F. Highlighting the importance of healthy sleep patterns in the risk of adult asthma under the combined effects of genetic susceptibility: a large-scale prospective cohort study of 455 405 participants. BMJ Open Respir Res 2023; 10:10/1/e001535. [PMID: 37012064 PMCID: PMC10083878 DOI: 10.1136/bmjresp-2022-001535] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/17/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Individuals with asthma usually have comorbid sleep disturbances; however, whether sleep quality affects asthma risk is still unclear. We aimed to determine whether poor sleep patterns could increase the risk of asthma and whether healthy sleep patterns could mitigate the adverse effect of genetic susceptibility. METHODS A large-scale prospective study was performed in the UK Biobank cohort involving 455 405 participants aged 38-73 years. Polygenic risk scores (PRSs) and comprehensive sleep scores, including five sleep traits, were constructed. A multivariable Cox proportional hazards regression model was used to investigate the independent and combined effects of sleep pattern and genetic susceptibility (PRS) on asthma incidence. Subgroup analysis across sex and sensitivity analysis, including a 5-year lag, different covariate adjustments and repeat measurements were performed. RESULTS A total of 17 836 individuals were diagnosed with asthma during over 10 years of follow-up. Compared with the low-risk group, the HRs and 95% CIs for the highest PRS group and the poor sleep pattern group were 1.47 (95% CI: 1.41 to 1.52) and 1.55 (95% CI: 1.45 to 1.65), respectively. A combination of poor sleep and high genetic susceptibility led to a twofold higher risk compared with the low-risk combination (HR (95% CI): 2.22 (1.97 to 2.49), p<0.001). Further analysis showed that a healthy sleep pattern was associated with a lower risk of asthma in the low, intermediate and high genetic susceptibility groups (HR (95% CI): 0.56 (0.50 to 0.64), 0.59 (0.53 to 0.67) and 0.63 (0.57 to 0.70), respectively). Population-attributable risk analysis indicated that 19% of asthma cases could be prevented when these sleep traits were improved. CONCLUSIONS Individuals with poor sleep patterns and higher genetic susceptibility have an additive higher asthma risk. A healthy sleep pattern reflected a lower risk of asthma in adult populations and could be beneficial to asthma prevention regardless of genetic conditions. Early detection and management of sleep disorders could be beneficial to reduce asthma incidence.
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Affiliation(s)
- Bowen Xiang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- National Institute of Health Data Science of China, Shandong University, Jinan, People's Republic of China
| | - Mengxiao Hu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- National Institute of Health Data Science of China, Shandong University, Jinan, People's Republic of China
| | - Haiyang Yu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- National Institute of Health Data Science of China, Shandong University, Jinan, People's Republic of China
| | - Yike Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- National Institute of Health Data Science of China, Shandong University, Jinan, People's Republic of China
| | - Qing Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- National Institute of Health Data Science of China, Shandong University, Jinan, People's Republic of China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- National Institute of Health Data Science of China, Shandong University, Jinan, People's Republic of China
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Saelee R, Haardörfer R, Johnson DA, Gazmararian JA, Suglia SF. Racial/Ethnic and Sex/Gender Differences in Sleep Duration Trajectories From Adolescence to Adulthood in a US National Sample. Am J Epidemiol 2023; 192:51-61. [PMID: 36004702 PMCID: PMC10144618 DOI: 10.1093/aje/kwac156] [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: 11/15/2021] [Revised: 07/07/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023] Open
Abstract
Racial/ethnic and sex/gender disparities in sleep duration have been documented in adolescence and adulthood. Identifying racial/ethnic and sex/gender differences in sleep duration trajectories from adolescence to adulthood can inform interventions on the developmental periods individuals are most at risk for short sleep duration. We examined racial/ethnic and sex/gender differences in self-reported sleep duration trajectories from adolescence to adulthood using data from waves I, III, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (1994-2018; n = 12,593). Multigroup growth mixture modeling was used to enumerate sleep duration trajectories from adolescence to adulthood. There were 3 common trajectory types across race/ethnicity and sex/gender groups: 1) consistent increasing short sleepers (i.e., increasing probability of short sleep into adulthood) (67.3%); 2) late-onset short sleepers (i.e., no probability of short sleep duration in adolescence until adulthood) (20.2%); and 3) early-onset short sleepers (i.e., declining probability of short sleep duration from adolescence into adulthood) (12.5%). The prevalence of the consistent-increasing trajectory was highest among Black male respondents, while late onset was highest among White female respondents and early onset greatest among Latinx male respondents. Findings underscore the need to intervene in early adolescence to prevent short sleep duration in adulthood.
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Affiliation(s)
- Ryan Saelee
- Correspondence to Dr. Ryan Saelee, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 (e-mail: )
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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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Hu Z, Tian Y, Song X, Hu K, Yang A. Associations Between Incident Asthma With Comorbidity Profiles, Night Sleep Duration, and Napping Duration Trajectories: A 7-Year Prospective Study. Int J Public Health 2022; 67:1604939. [PMID: 35872705 PMCID: PMC9305997 DOI: 10.3389/ijph.2022.1604939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: We aim to determine whether comorbidity profiles, night sleep duration, and napping duration trajectories were associated with incident asthma in Chinese adults.Methods: A total of 7,655 community-dwelling individuals were included in this study. Latent class/profile analysis(LCA/LPA) identified comorbidity profiles, night sleep duration, and napping duration trajectories. A generalized additive model with binomial regression assessed the associations between incident asthma with sleep trajectories.Results: During a 7-year follow-up period, 205 individuals were newly diagnosed with asthma. LPA identified four trajectories of night sleep duration: dominant short (n = 2,480), dominant healthy-long (n = 1,405), long decreasing (n = 1875), and short increasing (n = 1895). We also found three trajectories of napping duration: short increasing (n = 3,746), stable normal (n = 1,379), and long decreasing (n = 2,530). We found three comorbidity profiles: dominant heart diseases or risks (n = 766), multiple disorders (n = 758), and minimal or least disorders (n = 6,131). Compared with dominant short night sleep duration, three other trajectories were associated with significantly decreasing incident asthma. Minimal or least disorders profile was associated with a significant reduction of new-onset asthma than two other comorbidity profiles in dominant short night sleep duration.Conclusion: Our findings suggested that a dominant short night sleep duration trajectory potentially increases incident asthma in Chinese adults.
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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, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital at Zhijiang, Zhijiang, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Yufeng Tian
- Department of Academic Management, China Three Gorges University, Yichang, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ailan Yang
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital at Zhijiang, Zhijiang, China
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Evans C, Fidler A, Baker D, Wagner M, Fedele D. Sleep and asthma management in youth with poorly-controlled asthma and their caregivers: a qualitative approach. J Asthma 2022; 59:1131-1138. [PMID: 33827372 PMCID: PMC10072859 DOI: 10.1080/02770903.2021.1914650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Youth with poorly-controlled asthma are at increased risk for sleep disturbances caused by nocturnal symptoms like coughing. Asthma-related sleep disturbances can have downstream consequences for youth with asthma and their families. This study aims to describe (1) sleep disturbances in adolescents with poorly-controlled asthma and their caregivers and (2) the relationship between sleep and asthma management. METHODS Adolescents with poorly-controlled asthma and their caregivers completed the Family Asthma Management System Scale (FAMSS), a semi-structured interview that assesses youth asthma management within the family context. Interviews were audio-recorded and transcribed. Two authors coded each transcript for sleep-related data in NVivo using descriptive content analysis. RESULTS Thirty-three adolescents ages 12-15 years old (M = 13.2, SD = 1.2) with poorly-controlled asthma and their caregivers participated in this study. Four main themes emerged: sleep difficulties, sleep environment, sleep and self-management, and fatigue and self-management. 42% of youth and caregivers reported worse nocturnal asthma symptoms (e.g. coughing) that caused frequent nighttime awakening. Approximately 27% of caregivers expressed distress over their child's nocturnal asthma and described their management strategies (e.g. co-sleeping, nighttime symptom monitoring). Adolescents described sleepiness as a barrier to asthma self-management tasks (e.g. medication adherence, response to exacerbation). CONCLUSION Interview responses demonstrated the considerable interrelationship of sleep and asthma management in adolescents with poorly-controlled asthma. Asthma providers should consider discussing sleep difficulties with their adolescent patients and their families. Addressing these difficulties may help adolescents improve their asthma self-management and help caregivers better cope with their child's disease.
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Affiliation(s)
- Corinne Evans
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea Fidler
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Dawn Baker
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - Mary Wagner
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - David Fedele
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Chen Y, Zhao A, Lyu J, Hu Y, Yin Y, Qu J, Tong S, Li S. Association of delayed chronotype with allergic diseases in primary school children. Chronobiol Int 2022; 39:836-847. [PMID: 35282724 DOI: 10.1080/07420528.2022.2040527] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To investigate the associations of sleep midpoint for both weekdays and weekends, and chronotype, with allergic diseases, specifically asthma, allergic rhinitis, and eczema in primary school children. In this cross-sectional study, we evaluated 10409 children between 7 and 12 years of age (mean 9.21 ± 1.51 years; male 52.2%). Each allergic disease was defined as children with both diagnosed disease and current symptoms, and the reference group was described as children without any allergic symptoms. Sleep durations and mid-sleep times were calculated by reported sleep timing. Chronotype was determined by mid-sleep time on free days corrected for oversleeping. Children with allergies have shorter sleep duration and later sleep preferences. Late weekly sleep midpoints were associated with higher odds of allergies, and the odds were even higher for later weekday midpoints than their weekend counterparts. Regarding chronotype, the more evening chronotype, the higher the odds of allergic rhinitis and eczema. Additionally, effect of weekday late sleep midpoint on allergies was stronger as the participants who slept less (asthma: aOR,1.62, 95 CI%,1.25-2.10, p < .001; allergic rhinitis: aOR,2.12, 95 CI%,1.68-2.67, p < .001; eczema: aOR, 1.94, 95 CI%,1.52-2.48, p < .001). Further, the associations of chronotype with allergic rhinitis were confounded by second-hand smoking exposure. Our study, which finds an association between chronotype and the odds of three allergic diseases, hopes to improve sleep health awareness, especially in the particular population with allergic diseases, and describes the importance of evaluating modifiable behavioral factors, such as sleep habits, as a plausible factor for the prevention and treatment of allergic diseases.
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Affiliation(s)
- Yiting Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anda Zhao
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajun Lyu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yabin Hu
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Yin
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajie Qu
- Childcare Department, Shanghai Municipal Education Commission, Shanghai, China
| | - Shilu Tong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Heterogeneous Condition of Asthmatic Children Patients: A Narrative Review. CHILDREN 2022; 9:children9030332. [PMID: 35327702 PMCID: PMC8947522 DOI: 10.3390/children9030332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 11/17/2022]
Abstract
Currently, asthma represents the most common chronic disorder in children, showing an increasingly consistent burden worldwide. Childhood asthma, similar to what happens in adults, is a diversified disease with a great variability of phenotypes, according to genetic predisposition of patients, age, severity of symptoms, grading of risk, and comorbidities, and cannot be considered a singular well-defined disorder, but rather a uniquely assorted disorder with variable presentations throughout childhood. Despite several developments occurring in recent years in pediatric asthma, above all, in the management of the disease, some essential areas, such as the improvement of pediatric asthma outcomes, remain a hot topic. Most treatments of the type 2 (T2) target phenotype of asthma, in which IL-4, IL-5, and IL-13 modulate the central signals of inflammatory reactions. Although, there may be an unresolved need to identify new biomarkers used as predictors to improve patient stratification using disease systems and to aid in the selection of treatments. Moreover, we are globally facing many dramatic challenges, including climate change and the SARS-CoV2 pandemic, which have a considerable impact on children and adolescent asthma. Preventive strategies, including allergen immunotherapy and microbiome evaluation, and targeted therapeutic strategies are strongly needed in this population. Finally, the impact of asthma on sleep disorders has been reviewed.
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