How Poor Sleep Habits Could Double Your Asthma Risk

Good sleep is important for health, even for the lungs and respiratory system. In fact, poor quality sleep can double the risk of an asthma diagnosis by increasing genetic susceptibility, according to a UK Biobank study. Early detection and treatment of sleep disorders can help reduce these risks, regardless of genetic predisposition.

Healthy sleep patterns are linked to lower risk in adults, a large study shows.

A UK Biobank study published in BMJ Open Respiratory Research suggests that poor quality sleep can increase an individual’s genetic susceptibility to asthma, potentially doubling the risk of diagnosis. The study included 455,405 participants aged 38-73 whose sleep patterns and genetic asthma risk scores were analyzed. The results showed that people with a high genetic risk and poor sleep patterns were 122% more likely to be diagnosed with asthma than those with a low genetic risk and a healthy sleep pattern. Researchers suggest that early detection and treatment of sleep disorders can help reduce the risks of asthma, regardless of genetic predisposition.

Poor quality sleep can strengthen a person’s genetic susceptibility to asthma, potentially doubling their risk of being diagnosed with the condition, suggests a large UK Biobank study published in the journal BMJ Open Respiratory Research.

A healthy sleep pattern appears to be associated with a lower risk of asthma, leading researchers to suggest that early detection and treatment of sleep disorders may reduce risks, regardless of genetic predisposition.

People with asthma often report sleep disturbances, including disturbed/short sleep and insomnia. But it’s not clear whether sleep quality itself can affect asthma risk, or whether healthy sleep patterns can reduce that risk, the researchers say.

In an effort to find out, they recruited 455,405 UK Biobank participants who were aged between 38 and 73 when they registered between 2006 and 2010.

Participants were asked about their sleep patterns, based on five specific traits: early or late chronotype (‘morning lark’ or ‘night owl’); sleep duration; insomnia; snoring; and excessive daytime sleepiness.

A healthy sleep pattern was defined as an early chronotype; 7-9 hours of sleep every night; never or rarely insomnia; no snoring; and without frequent daytime sleepiness.

Based on their responses, 73,223 people met the criteria for a healthy sleep pattern; 284,267 an intermediate sleep pattern; and 97,915 a poor sleep pattern.

The genetic makeup of all UK Biobank participants is routinely mapped, and a genetic asthma risk score for each of the 455,405 people in this study was mapped according to the number of asthma-related genetic variants in their genome.

About 1 in 3 participants were classified as ‘high’ genetic risk (150,429) and another third (151,970) as ‘intermediate’ risk. The remainder were classified as ‘low’ risk.

Participants’ respiratory health was tracked until the date of asthma diagnosis, death, or March 31, 2017, whichever came first.

During a monitoring period of just under 9 years, 17,836 people were diagnosed with asthma. They were more likely to have potentially influential risk factors than those not diagnosed with the condition.

These were: lower levels of education and a greater likelihood of unhealthy sleep traits and patterns; obesity; higher genetic risk scores for asthma; higher levels of smoking and drinking; high blood pressure, diabetes, depression, acid reflux; and greater exposure to air pollution.

About 7,105 people with high genetic risk of asthma and 5,748 with intermediate genetic risk were diagnosed with the condition during the monitoring period.

Compared to those with low genetic risk, those with the highest risk were 47% more likely to be diagnosed with asthma, while those with a poor sleep pattern were 55% more likely.

But people with a high genetic risk who also reported poor sleep patterns were 122% more likely to be diagnosed with asthma than those with a healthy sleep pattern and a low genetic risk—in other words, they had more than twice as likely to be diagnosed with asthma.

All five sleep traits were independently associated with lower risks for asthma, with never/rare insomnia and sleep duration of 7–9 hours per night appearing most influential, with risk reductions of 25% and 25%, respectively. 20%.

A further in-depth analysis in a smaller group of people showed that a healthy sleep pattern can reduce the risk of asthma in those at high genetic risk by 37%, suggesting that a healthy sleep pattern can help in asthma risk compensation, regardless of genetic susceptibility. say the researchers.

In theory, at the population level, a low genetic risk combined with a healthy sleep pattern could translate into 19% fewer cases of asthma, the researchers suggest.

The link between sleep and asthma may be bidirectional, they suggest, offering several possible explanations for their findings.

“The negative impact of sleep disturbances on asthma, which is generally considered a chronic inflammatory disease, may be mediated by sleep-induced chronic inflammation. Previous studies have shown that sleep disorders, such as unfavorable sleep duration and insomnia, are associated with chronic inflammation.

“In theory, the immune response to inflammation could generate pro-inflammatory cytokines that result in cellular infiltration and airway inflammation, further increasing the risk of asthma,” they write.

This is an observational study, and as such cannot determine causation, and the researchers acknowledge some limitations to their findings.

As the UK Biobank only provided information for 38-73 year olds, the effect on children and younger adults is still unclear, adding that the findings only apply to people of European descent. Finally, the UK Biobank may be subject to a ‘healthy volunteer’ bias.

However, the researchers conclude: “Given that poor sleep combined with high genetic susceptibility confers a greater than two-fold risk of asthma, sleep patterns can be recommended as an effective lifestyle intervention to prevent asthma in the future, especially for individuals with high-risk genetics.”

Reference: “Highlighting the importance of healthy sleep patterns in adult asthma risk under the combined effects of genetic susceptibility: a large-scale prospective cohort study of 455,405 participants” by Bowen Xiang, Mengxiao Hu, Haiyang Yu, Yike Zhang, Qing Wang, and 6Fuzhong Xue, April 3, 2023, BMJ Open Respiratory Research.
DOI: 10.1136/bmjresp-2022-001535

Funding: Future Program for Young Researchers and National Research and Development Programme