Narendra U.1, Sandeepa H.S.2, Deepak U.G.3, K.C. Agarwal4, Priyanka Rodrigues5, Supriya Sandeepa6
BACKGROUND
Several studies showed that quality of sleep is reduced in asthma, but majority of
the studies have used subjective methods for assessment of quality of sleep. This
study was carried out to objectively measure quality of sleep using various sleep
parameters by polysomnography in asthmatics and compare these sleep
parameters with level of asthma control and with severity of airway limitation.
METHODS
This is a cross sectional study conducted among 50 adult asthma patients. History
of the patients was taken. Patients included in the study were assessed clinically
for asthma control, spirometry and each one of them was subjected to overnight
level 1 polysomnography. Level of asthma symptom control was done depending
on the daytime symptoms, reliever usage, night awakenings and activity limitation.
Level of asthma control and airway limitation, forced expiratory volume in 1 second
(FEV1) were compared with various sleep parameters. Tukey's post hoc test was
performed to check as to which specific independent variable level significantly
differs from the other.
RESULTS
Among 50 patients, 32 were men, mean age of the study population was 46.04
years. Mean sleep efficiency of study population was 76 ± 10.34 %. Average
apnoea-hypopnea index (AHI) of the population was 7.86 / hr. Arousal index was
13.22 / hr. and desaturation index was 11.46 / hr. in asthmatics. Uncontrolled
asthma patients had lower sleep efficiency (67.05 ± 8.19 % vs. 83 ± 5.5 %),
longer sleep onset latency (29.11 ± 5.48 min vs. 23.25 ± 6.2 min), higher AHI
(15.03 ± 10.1 / hr. vs. 1.57 ± 0.6 / hr.), more frequent arousals (23.32 ± 13.4 /
hr. vs. 3.31 ± 2.42 / hr.) and more desaturations (18.72 ± 7.76 / hr. vs. 1.66 ±
1.53 / hr.) compared to well controlled asthma patients. Similar correlation was
found with severe airway limitation.
CONCLUSIONS
Sleep quality is reduced in asthmatics. Optimal management targeting good
asthma control and preventing the airway limitation is the key to achieve good
quality of sleep and good quality of life. Subjective assessment in the form of
questionnaires can be used as screening tools to evaluate the sleep;
polysomnography can be used for confirmation.
