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

Chest. 2016 Dec;150(6):1242-1250. doi: 10.1016/j.chest.2016.09.020. Epub 2016 Oct 6.


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.

Keywords: asthma; depression; health care utilization; insomnia; quality of life.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study

MeSH terms

  • Anxiety / epidemiology
  • Asthma / complications*
  • Asthma / physiopathology
  • Asthma / psychology
  • Depression / epidemiology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Quality of Life
  • Respiratory Function Tests
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Surveys and Questionnaires