Asthma is one of the most common respiratory disorders, affecting approximately 262 million people annually. It usually starts from an early age and symptoms can differ from one patient to another.
The exact cause of the disease is yet unknown. However, several factors come into play, the main ones being genetics and environmental conditions. In asthmatic patients, there is a narrowing of the airways and sometimes an excessive production of mucus. This leads to the characteristic symptoms of asthma:
- Coughing
- Difficulty breathing
- Wheezing
- Shortness of breath
Sleep plays a crucial role in maintaining good health. Disturbances in the sleep cycle can have various effects on an individual, one of them being the worsening of the asthmatic symptoms. In fact, it was found that poor sleep quality is associated with worse asthmatic symptoms the next day. Nocturnal asthma is a sleep-related type of asthma. It is mainly characterised by a 15% decrease in the forced expiratory volume in one second, between falling asleep and waking up. Some patients can even experience a 50% decrease in the forced expiratory volume. The worsening of asthma at night could be due to a variety of reasons such as variations in the biological clock of the body, also known as the circadian rhythm. These variations can affect the secretion of hormones such as cortisol, epinephrine and the sleep hormone, melatonin.
Obstructive Sleep Apnoea (OSA) was also found to be more prevalent among asthmatic patients. Sleep apnoea symptoms are related to the severity of asthma in each patient.
Lack of sleep due to asthmatic episodes can have negative effects on the patients, which can make them more prone to developing infections due to a weakened immune system. In addition, it takes a toll on the learning ability of the patient, as well as their mental health due to the anxiety induced by the lack of sleep.
Fortunately, treatments for asthma are available. They differ from one type of asthma to another, but the main ones used nowadays are corticosteroid inhalers and Leukotriene receptor antagonists tablets. However, asthma remains an incurable disease that needs to be properly managed to ensure the best outcome for the patient.
To conclude, there is a clear relationship between lack of sleep and asthma. Asthma is associated with difficulties going to sleep, poor sleep quality, interrupted sleep and therefore an increase in daytime sleepiness. While corticosteroids present a solid treatment for asthma, it is not enough to solely rely on them in the case of nocturnal asthma. It is important to evaluate asthma on a 24-hour basis to collect valuable information regarding the sleep/awake state of the patient, the use of asthma medication and the variation of the symptoms. Proper management of asthma ensures an improved quality of sleep and a decrease in the effects of lack of sleep.
References
- Atanasov, S. and Calhoun, W., 2007. The Relationship Between Sleep and Asthma. Sleep Medicine Clinics, 2(1), pp.9-18.
- Cukic, V., Lovre, V. and Dragisic, D., 2011. Sleep Disorders in Patients with Bronchial Asthma. Materia Socio Medica, 23(4), p.235.
- Kong, D., Qin, Z., Shen, H., Jin, H., Wang, W. and Wang, Z., 2017. Association of Obstructive Sleep Apnea with Asthma: A Meta-Analysis. Scientific Reports, 7(1).
- Mayo Clinic. 2022. Asthma - Symptoms and causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653.> [Accessed 22 April 2022].
- Meltzer, L. and Pugliese, C., 2017. Sleep in young children with asthma and their parents. Journal of Child Health Care, 21(3), pp.301-311.
- Who.int. 2022. Asthma. [online] Available at: <https://www.who.int/news-room/fact-sheets/detail/asthma> [Accessed 22 April 2022].
