title: Association Between Insomnia and Asthma Burden in the Severe Asthma Research Program (SARP) III.
abstract: BACKGROUND
  Sleep difficulties are commonly reported by patients with asthma; however, the prevalence of insomnia and its association with disease burden and well-being is unknown. We aimed to determine the prevalence of insomnia, defined as combined sleep-specific complaints with associated daytime symptoms, among a large sample of adults with asthma, and to compare well-being, asthma control, and asthma-related health care utilization in individuals with asthma and insomnia and those without insomnia.
  
  
  METHODS
  Baseline data from adults with physician-confirmed asthma enrolled in the Severe Asthma Research Program III was used for analyses (N = 714). Participants completed the Insomnia Severity Index (ISI), Asthma Control Test, Asthma Quality of Life Questionnaire, and Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  Insomnia (ISI ≥ 10) was identified in 263 participants (37%). Presence of insomnia was associated with higher levels of depression and anxiety symptoms and poorer quality of life. Those with insomnia had a 2.4-fold increased risk for having not well-controlled asthma and a 1.5-fold increased risk for asthma-related health care utilization in the past year compared with those without insomnia.
  
  
  CONCLUSIONS
  Insomnia is highly prevalent in asthma and is associated with adverse outcomes. Further studies are needed to gain a better understanding of the interaction between insomnia and asthma control.
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA. Electronic address: luysterfs@upmc.edu.
authors.forename: Faith S
authors.initials: FS
authors.lastname: Luyster
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; VA Pittsburgh Healthcare System, Pittsburgh, PA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Strollo
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Holguin
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors.forename: Mario
authors.initials: M
authors.lastname: Castro
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California San Francisco School of Medicine, San Francisco, CA.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Dunican
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California San Francisco School of Medicine, San Francisco, CA.
authors.forename: John
authors.initials: J
authors.lastname: Fahy
authors.affiliation: Division of Pediatric Allergy and Immunology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gaston
authors.affiliation: Pulmonary Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Elliot
authors.initials: E
authors.lastname: Israel
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine, Madison, WI.
authors.forename: Nizar N
authors.initials: NN
authors.lastname: Jarjour
authors.affiliation: Department of Public Health Science, The Pennsylvania State University College of Medicine, Hershey, PA.
authors.forename: David T
authors.initials: DT
authors.lastname: Mauger
authors.affiliation: Department of Medicine, Division of Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Moore
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Sally E
authors.initials: SE
authors.lastname: Wenzel
mesh_terms: D001007:Anxiety / Q000453:epidemiology; D001249:Asthma / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012129:Respiratory Function Tests; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: asthma; depression; health care utilization; insomnia; quality of life