Impact of Sleep on Asthma: A Scoping Review

Background: While the impact asthma has on sleep disturbances is well-described, the impact that sleep can have on asthma is less understood. Therefore, the purpose of this review was to examine the evidence surrounding how sleep impacts asthma. Methods: A literature search was performed from August 17 to September 5, 2023, in four databases following the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Inclusion criteria included cross-sectional, cohort, and observational studies published in English that evaluated adult populations with clear directionality of sleep impacting asthma. Two independent reviewers used an iterative process for abstract and full-text review. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool for each study type. Results: Of 919 studies, 13 met inclusion criteria and were analyzed. Sleep was assessed through the Pittsburgh Sleep Quality Index (no. = 6), the Epworth Sleepiness Scale (no. = 5), self-reported sleep duration (no. = 4), and actigraphy (no. = 2). Asthma was assessed through asthma control surveys (no. = 11), spirometry (no. = 7), inflammatory biomarkers (no. = 3), and a quality-of-life survey (no. = 1). Twelve studies (92%) determined that sleep quality and/or duration impacted asthma control, quality of life, and healthcare utilization. One study (8%) found no association between sleep parameters and asthma control in individuals with well-controlled asthma. Conclusions: Poor sleep quality is associated with poorer asthma control, more frequent asthma exacerbations, and reduced quality of life. Further research using valid and reliable self-report and objective measures is needed to characterize sleep disturbances in individuals with asthma and to assess the impact that sleep disturbances have on asthma.