Waking up to sleep health in asthma

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Sleep disorders such as insomnia and obstructive lung disease such as asthma are quite prevalent in Australia. Comorbid insomnia and asthma present a classic ‘Catch-22’ as nocturnal symptoms of asthma can wake patients up from sleep, whereas the worry and anxiety stemming from sleep loss can trigger asthma, Natural circadian rhythms interact with the insomnia-asthma cycle as hormonal and inflammatory cascades impact breathing during sleep. Nocturnal asthma symptoms represent poorly controlled disease. Often insomnia symptoms are considered to be secondary to another condition, and clinicians and patients may ignore insomnia symptoms, though current guidelines clearly suggest that insomnia needs to be treated on its own ground regardless of comorbid conditions. Epidemiological data also suggest that asthma and insomnia often occur together. However, how asthma patients recognise sleep issues, how they prioritise sleep issues versus asthma symptoms, how they seek treatment and adhere to recommended treatments is not well studied – representing a key gap in clinical understanding. This data is essential for developing and evaluating sleep health management guidelines for those with asthma. This project will utilise initial exploratory research with asthma patients to develop instruments to assess sleep health in asthma patients that can be utilised in a clinical setting.

Program Type: MPhil, PhD

Supervisors: Dr Juliet Foster, A/Prof Bandana Saini, Dr Janet Cheung, Prof Carol Armour

Synopsis: Poor sleep health in patients with asthma can impact overall health as well as asthma outcomes. Often this aspect of quality of life is not assessed in clinical encounters with asthma patients; currently there are no specific instruments that are available to assess aspects of sleep health in people with asthma. Having such measures readily available will allow respiratory clinicians to assess patients’ sleep health and provide appropriate treatment and health education to improve sleep quality.

Research Plan: This project will consist of 2 phases.

In phase 1, qualitative methods employing semi structured interviews with asthma patients reporting sleep disorders will be used initially. Interview data will be thematically analysed using a framework approach. The results of these interviews will inform the development of a survey to measure sleep health experiences in those with asthma; this survey will be conducted with a nationally representative sample.

In phase 2, the data from phase will be used to construct a brief tool to assist health professionals in screening their asthma patients for sleep health problems. This instrument will then be pilot tested for its clinical utility in a small group of clinicians managing asthma patients.

Significance: The significance of this work is that it will provide a clinically useful tool to assess sleep health in patients with asthma. This will allow respiratory clinicians to gauge sleep quality in patients with asthma and provide targeted treatment and support to patients to improve their sleep health.

Funding: N/A

Candidate: 

  • Bachelor degree in health or medical science-related discipline with honours.
  • Passion and motivation to make a difference in patient living with asthma.

Contact: Dr Juliet Foster juliet.foster@sydney.edu.au