Sleep Quality and Asthma Control in Urban Populations

Urban environments impose a unique set of stressors on individuals with asthma, including exposure to air pollution, noise, overcrowding and psychosocial pressures. These factors often exacerbate nocturnal symptoms, leading to fragmented or shortened sleep. In turn, poor sleep quality contributes to systemic inflammation, impaired lung function and reduced response to standard asthma therapies. The relationship is bidirectional: suboptimal asthma control disrupts sleep through nocturnal coughing, wheezing and breathlessness, while disturbed sleep amplifies airway hyperresponsiveness and diminishes quality of life. Socioeconomic disparities in housing, access to healthcare and shift-work patterns further compound this cycle in densely populated settings. Effective management therefore requires integration of sleep assessment into routine asthma care, personalised behavioural and environmental interventions, and community-based monitoring programmes. Such a holistic approach holds promise for reducing emergency visits and improving long-term outcomes in urban populations worldwide.

Research from Nature Portfolio

Recent studies have demonstrated a high prevalence of sleep disturbance among adults attending urban pulmonary clinics, with more than half of patients reporting poor sleep quality. Those with partially controlled or uncontrolled asthma exhibited significantly higher scores for insomnia severity and daytime sleepiness compared to well controlled cases. Multimodal questionnaires revealed that obstructive sleep apnoea risk and clinical insomnia were particularly common in individuals with suboptimal control, suggesting that screening for sleep-related breathing disorders and insomnia should form part of comprehensive asthma management. These findings emphasise that sleep quality is not merely a symptom of asthma but a modifiable determinant of disease control.

Sleep Quality and Asthma Control in Urban Populations publication trend

The graph below shows the total number of articles in sleep quality and asthma control in urban populations across all publications each year (not limited to Nature Index journals).

Technical terms

Asthma control: The extent to which symptoms are minimised and treatment goals are met, including the absence of nocturnal awakenings.

Sleep quality: A multidimensional measure that encompasses sleep duration, continuity, depth and subjective satisfaction.

Pittsburgh Sleep Quality Index (PSQI): A self-rated questionnaire evaluating sleep quality and disturbances over a one-month period.

Fractional exhaled nitric oxide (FeNO): A non-invasive biomarker indicating eosinophilic airway inflammation.

Peak expiratory flow rate (PEFR): The maximum speed of expiration, used to monitor airway obstruction and variability.

Comorbidity: The presence of one or more additional chronic conditions co-occurring with a primary disease, such as obesity or depression in asthma.

References

1. The prevalence of sleep disturbance among asthmatic patients in a tertiary care center. Scientific Reports (2021).
2. The Effect of Short Sleep Duration on the Development of Asthma. International Journal of Clinical Practice (2022).
3. Associations Between Incident Asthma With Comorbidity Profiles, Night Sleep Duration, and Napping Duration Trajectories: A 7-Year Prospective Study. International Journal of Public Health (2022).
4. Daytime Sleepiness in Children With Asthma: Examining Respiratory and Non-respiratory Factors. Cureus (2023).