Controlling Asthma May Improve Sleep Quality

In an effort to improve the quality of sleep for patients with asthma, a recent study shows that a comprehensive sleep history of patients with poorly controlled asthma is key to capturing an accurate measurement of sleep quality and daytime sleepiness in symptomatic asthmatics, as well as the effects of improved asthma control on sleep quality.

The study, co-authored by a researcher and clinician at The Ohio State University Medical Center, is published in the Journal of Asthma.

"The research shows that sleep disturbances are common in asthmatics and are associated with asthma control and quality of life," says Dr. John Mastronarde, a pulmonologist and director of the asthma center at Ohio State's Medical Center. "Current guidelines for management of asthma recommend asking patients about nocturnal asthma symptoms, but guidelines do not advise that clinicians take a global sleep history from their asthma patients.

"Conceivably, nocturnal sleep-related disturbances, in addition to poor daytime function related to fragmented sleep, would not be detected in a routine history taken from patients with asthma," adds Mastronarde.

More than 70 percent of asthmatics have difficulty sleeping at night and 65 percent of asthma deaths occur during sleep.

The large, multi-center randomized outpatient clinical trial evaluated the effect of a drug used to open airways to the lungs in patients with mild to moderate persistent asthma. The drug, theophylline, was compared to a similar drug, montelukast, also prescribed to improve breathing, and a placebo. Patients were instructed to take one low-dose capsule daily after dinner. Participants were not told whether the tablet was one of the two drugs or the placebo.

The 487 patients involved in the study had either mild obstruction or normal lung function, but poorly controlled asthma and an asthma-related quality of life. Over the course of six months, they received routine follow-up including various traditional breathing tests for asthmatics, sleep symptom questionnaires evaluating nocturnal asthmatic symptoms such as wheezing, coughing, shortness of breath, chest pain, heartburn and palpitations, and were contacted by telephone to assess compliance, side effects and asthma control.

"Our data showed better sleep quality was associated with improvement in asthma control and asthma-related quality of life, but not with changes in pulmonary function," said Mastronarde. "In addition, sleep quality was not affected by six months of treatment with either low-dose theophylline or montelukast."