Sleep duration, asthma and obesity

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BACKGROUND: Obesity is more prevalent in asthmatics. Sleep duration is a novel risk factor for obesity in general populations. OBJECTIVE: We tested the association of sleep duration and asthma characteristics with obesity. METHODS: Adults at tertiary clinics were surveyed on asthma symptoms and habitual sleep duration. Medical records were used to assess asthma severity step (1-4), extract height and weight, current medications and diagnosed comorbid conditions. BMI ≥30 kg/m(2) defined obesity. Habitual sleep was categorized as <6 (very short), 6 to <7 h (short), 7-8 h (normal), >8 to ≤9 h (long) and >9 h (very long). Inhaled corticosteroid doses were categorized as low, moderate and high. RESULTS: Among 611 participants (mean BMI 30 ± 8), 249 (41%) were obese. After adjustment for covariates, obesity was associated with short and very long sleep: as compared to normal sleepers, the odds of being obese were on an average 66% higher ([95% CI: 1.07-2.57], p = 0.02) among short and 124% higher ([1.08-1.65], p = 0.03) among very long sleepers, and the association with very short sleep approached significance (1.74 [0.96-3.14], p = 0.06). Obesity was also significantly related to highest asthma step (1.87 [1.09-3.21], p = 0.02) and psychopathology (1.64 [1.08-2.48], p = 0.02), and a trend was seen with high-dose inhaled corticosteroids (1.82 [0.93-3.56], p = 0.08). CONCLUSIONS: Obesity in asthmatics is associated with shorter and very long sleep duration, worse asthma severity, psychopathology and high-dose inhaled corticosteroids. Although this cross-sectional study cannot prove causality, we speculate that further investigation of sleep may provide new opportunities to reduce the rising prevalence of obesity among asthmatics.