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Do nocturnal asthma attacks influence sleep parameters and inflammatory markers? A cross-sectional population-based study

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Abstract

Purpose

To evaluate the effects of nocturnal asthma on sleep parameters and inflammatory markers according to the severity of the condition in participants in the São Paulo Epidemiologic Sleep Study (EPISONO).

Methods

Data from the 2007 and 2018 editions of the EPISONO study were utilized. Subjects completed validated sleep and respiratory questionnaires, underwent nocturnal polysomnography and spirometry tests, and provided blood samples for the assessment of inflammatory parameters.

Results

Of 72 participants (67% women), 53% (n = 38) had intermittent nocturnal asthma symptoms and 47% (n = 34) had persistent asthma (mild, moderate, and severe). Individuals with persistent nocturnal symptoms had a higher body mass index (BMI), were more likely to have respiratory symptoms, and had worse lung function, a higher apnea-hypopnea index (AHI), and higher desaturation index than individuals with intermittent nocturnal symptoms. Positive associations were identified between nocturnal asthma and obstructive sleep apnea (OSA). A higher frequency of OSA was observed in participants with persistent asthma and participants with OSA were more likely to have persistent than intermittent asthma. However, there were no significant differences between the immunological parameters of those with intermittent or persistent asthma.

Conclusions

This study highlights the relevance of nocturnal symptoms as a valuable indicator of asthma severity. The findings also add to the existing body of evidence linking nocturnal asthma and OSA.

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Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

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Funding

Our studies are supported by grants from the Associacão Fundo de Incentivo à Pesquisa (AFIP) and Sao Paulo Research Foundation (FAPESP #2020/13467-8 to MLA and #2021/13004-0 to DSR). M.L.A. and D.S.R. are Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) fellowship recipients.

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Authors and Affiliations

  1. Sleep Institute, São Paulo, Brazil

    Maingredy Rodrigues Souza, Tathiana A. Alvarenga, Priscila K. Morelhão, Sergio Tufik & Monica L. Andersen

  2. Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, Brazil

    Daniela Santoro Rosa

  3. Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, SP, 04024-002, Brazil

    Priscila K. Morelhão, Sergio Tufik & Monica L. Andersen

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  1. Maingredy Rodrigues Souza
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  3. Tathiana A. Alvarenga
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  4. Priscila K. Morelhão
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Contributions

The study was designed by M.R.S., M.L.A., D.S.R., T.A.A., and S.T. P.K.M. assisted with the statistical analysis. The preparation of the manuscript, including revising the text format, references, terminology, and overall structure, was a collaborative effort involving M.R.S., M.L.A., D.S.R., T.A.A., S.T., and P.K.M.

Corresponding author

Correspondence to Monica L. Andersen.

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The study was approved by the Ethics Committee of Universidade Federal de São Paulo (CEP: 593/2006; 0985/2017).

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Souza, M.R., Rosa, D.S., Alvarenga, T.A. et al. Do nocturnal asthma attacks influence sleep parameters and inflammatory markers? A cross-sectional population-based study. Sleep Breath 28, 619–627 (2024). https://doi.org/10.1007/s11325-023-02935-9

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