There’s a strong connection between poor sleep quality and the risk of severe asthma exacerbations in children with moderate to severe asthma. That’s according to the findings of researchers from Indiana University Health in Indianapolis. Their study, “Predictive Correlates of Poor Sleep Associated With Increased Risk of Severe Asthma Exacerbations Among Children With Moderate-To-Severe Asthma,” was published in Pediatric Allergy and Immunology.
Results of the multiyear, retrospective cohort analysis suggest that sleep fragmentation and untreated sleep disturbances may significantly increase the likelihood of emergency room visits and hospitalizations due to asthma.
Researchers analyzed data from 161 children who underwent sleep studies between August 2021 and December 2023 and found that a higher sleep arousal index — indicating frequent disruptions in brainwave activity during sleep — was associated with increased risk of severe asthma attacks, particularly among male patients. Boys with elevated arousal indices had 13% higher adjusted odds of experiencing a severe exacerbation, although there was no such association in girls.
According to the study’s authors, this is the first real-world evidence showing that sleep quality metrics can be used to predict asthma severity in children. Their findings highlight the importance of integrating sleep assessments into asthma care, especially for children who already show signs of poor sleep.
Other key findings from the study include:
- Children with a history of severe asthma attacks, and those prescribed inhaled corticosteroids combined with long-acting beta-agonists (ICS + LABA), were more likely to experience future exacerbations.
- Conversely, children who had been treated with sleep latency-reducing medications, such as melatonin, clonidine or hydroxyzine, showed a lower risk of severe asthma episodes.
- The inclusion of sleep-related factors in predictive models significantly improved the accuracy of forecasting future asthma attacks compared to models based solely on past exacerbation history.
The study also uncovered a surprising trend: Black children were less likely to experience frequent severe exacerbations than their white counterparts, though researchers caution that this finding may be influenced by unmeasured socioeconomic factors.
The study underscores the complex interplay between sleep and respiratory health and opens new avenues for preventive care in pediatric asthma management, the authors wrote. By identifying at-risk children earlier, clinicians can intervene before their asthma worsens, thereby reducing emergency visits, improving quality of life and lowering health care costs.
Researchers also emphasized the need for further clinical trials to validate the protective role of sleep medications and to explore scalable strategies for incorporating sleep studies into routine asthma management. They also called for increased awareness among pediatricians to screen for sleep disturbances in children with asthma.
