Luyster Faith S, Strollo Patrick J, Holguin Fernando, Castro Mario, Dunican Eleanor M, Fahy John, Gaston Benjamin, Israel Elliot, Jarjour Nizar N, Mauger David T, Moore Wendy C, Wenzel Sally E
School of Nursing, University of Pittsburgh, Pittsburgh, PA.
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; VA Pittsburgh Healthcare System, Pittsburgh, PA.
Chest. 2016 Dec;150(6):1242-1250. doi: 10.1016/j.chest.2016.09.020. Epub 2016 Oct 6.
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.
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.
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.
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.
哮喘患者普遍存在睡眠困难；然而，失眠的患病率及其与疾病负担和幸福感的关联尚不清楚。我们旨在确定在大量成年哮喘患者样本中失眠的患病率，失眠定义为特定睡眠相关主诉合并相关日间症状，并比较哮喘伴失眠患者与无失眠患者的幸福感、哮喘控制情况及哮喘相关医疗保健利用情况。
对参加重度哮喘研究项目III且经医生确诊为哮喘的成年人的基线数据进行分析（N = 714）。参与者完成了失眠严重程度指数（ISI）、哮喘控制测试、哮喘生活质量问卷及医院焦虑抑郁量表。
263名参与者（37%）被确定为失眠（ISI≥10）。失眠的存在与更高水平的抑郁和焦虑症状以及更差的生活质量相关。与无失眠者相比，失眠者在过去一年中哮喘控制不佳的风险增加2.4倍，哮喘相关医疗保健利用风险增加1.5倍。
失眠在哮喘患者中非常普遍，且与不良后果相关。需要进一步研究以更好地理解失眠与哮喘控制之间的相互作用。
