Sleep disturbances in clinically stable young asthmatic adults

Background: Although nocturnal asthma is a well documented clinical problem, the effect of asthma on sleep itself and morbidity caused thereby have not received adequate attention. It is now recognized that partial sleep deprivation has a considerable effect on human functions. Objectives: With this in view, we conducted a study to determine the occurrence and nature of sleep disturbances in a homogeneous group of patients with clinically stable bronchial asthma in their home environment. Methods: Thirty young adult unmarried university students with clinically stable bronchial asthma attending the Institute's outpatient department were asked to respond to an asthma/sleep questionnaire and were requested to maintain a sleep diary for 1 week. A similar group of 30 unmarried healthy young university students also underwent an identical workup and functioned as controls. Ten subjects from each group maintained a peak expiratory flow rate (PEFR) diary. Results: The questionnaire revealed that 28 (93%) of the 30 patients experienced sleep disturbances (average 2.7/subject) as compared to 10 (33%) subjects in the control group (average 0.4/subject). The sleep diary confirmed that 27 (90%) of the 30 patients had sleep disturbances (2.4/subject/wk) as compared with 8 (27%) subjects (0.3/subject/wk) in the control group. These differences were statistically significant. Daytime sleepiness and tiredness (63%) and difficulty in maintaining sleep (60%) along with early morning awakening (46%) were more frequently seen. The asthmatic patients also had a shorter duration of sleep (427 min) as compared with the controls (474 min). These findings were significantly different from the control group. Conclusions: Increased daytime sleepiness and tiredness was perhaps a reflection of the poor quality of sleep experienced by patients with clinically stable asthma. This consequently may lead to impaired daytime performance which can have a potentially serious effect for the patient and society.