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Original Research: Asthma |

Association Between Insomnia and Asthma Burden in the Severe Asthma Research Program (SARP) III

Faith S. Luyster, PhD; Patrick J. Strollo, Jr., MD; Fernando Holguin, MD, MPH; Mario Castro, MD; Eleanor M. Dunican, MD; John Fahy, MD; Benjamin Gaston, MD; Elliot Israel, MD; Nizar N. Jarjour, MD; David T. Mauger, PhD; Wendy C. Moore, MD; Sally E. Wenzel, MD
Author and Funding Information

The content of this article is solely the responsibility of the authors and does not represent the views of the National Institutes of Health.

FUNDING/SUPPORT: This study was funded by the National Institutes of Health [NIH U10HL 109164, U10HL 109257, U10HL 109250, U10HL 109172, U10HL 109168, U10HL 109152, U10HL 109046, U10HL 109046]. Support for the first author was provided by the National Heart, Lung, and Blood Institute (NHLBI) K23 HL105887.

aSchool of Nursing, University of Pittsburgh, Pittsburgh, PA

bDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA

cVA Pittsburgh Healthcare System, Pittsburgh, PA

dDivision of Pulmonary and Critical Care Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO

eDivision of Pulmonary and Critical Care Medicine, University of California San Francisco School of Medicine, San Francisco, CA

fDivision of Pediatric Allergy and Immunology, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH

gPulmonary Division, Brigham and Women’s Hospital, Boston, MA

hDivision of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine, Madison, WI

iDepartment of Public Health Science, The Pennsylvania State University College of Medicine, Hershey, PA

jDepartment of Medicine, Division of Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Wake Forest University School of Medicine, Winston-Salem, NC

CORRESPONDENCE TO: Faith S. Luyster, PhD, University of Pittsburgh School of Nursing, 3500 Victoria St, Room 415, Pittsburgh, PA 15261


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(6):1242-1250. doi:10.1016/j.chest.2016.09.020
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Background  Sleep difficulties are commonly reported by patients with asthma; however, the prevalence of insomnia and its association with disease burden and well-being is unknown. We aimed to determine the prevalence of insomnia, defined as combined sleep-specific complaints with associated daytime symptoms, among a large sample of adults with asthma, and to compare well-being, asthma control, and asthma-related health care utilization in individuals with asthma and insomnia and those without insomnia.

Methods  Baseline data from adults with physician-confirmed asthma enrolled in the Severe Asthma Research Program III was used for analyses (N = 714). Participants completed the Insomnia Severity Index (ISI), Asthma Control Test, Asthma Quality of Life Questionnaire, and Hospital Anxiety and Depression Scale.

Results  Insomnia (ISI ≥ 10) was identified in 263 participants (37%). Presence of insomnia was associated with higher levels of depression and anxiety symptoms and poorer quality of life. Those with insomnia had a 2.4-fold increased risk for having not well-controlled asthma and a 1.5-fold increased risk for asthma-related health care utilization in the past year compared with those without insomnia.

Conclusions  Insomnia is highly prevalent in asthma and is associated with adverse outcomes. Further studies are needed to gain a better understanding of the interaction between insomnia and asthma control.

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