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13th April 2023
According to Chinese researchers and based on an analysis of individuals in the UK Biobank, having a healthy sleep pattern appears to mitigate the effect of genetic susceptibility to asthma.
Asthma is a chronic respiratory inflammatory disease and which globally, has been estimated to affect between 9.8 and 17.9% of the population depending on whether the definition includes wheezing or ever wheeze. Although there are a number of potential causes of asthma including a family history and exposure to various allergens, the presence of a persistent short sleep duration is one factor identified as being associated with an increased risk of developing asthma. While genome-wide association studies have revealed some asthma loci, the variability of genetic influence suggests that several other, non-genetic exposures may also influence the development of asthma.
In the current study, researchers examined the association between sleep traits, genetic susceptibility and the risk of asthma in a UK Biobank cohort. The team undertook an analysis of those aged 38-73 years and for whom polygenic risk scores and comprehensive sleep scores, were constructed. The researchers used a multivariable Cox proportional hazard regression model to investigate the independent and combined effects of sleep pattern and genetic susceptibility on asthma incidence. Participants were assigned as being at a low, intermediate and high risk of asthma based on genetic susceptibility and sleep categorised as ‘healthy’, ‘intermediate’ and ‘poor’.
Healthy sleep pattern and development of asthma
From a total of 455,405 individuals with a mean age of 56.5 years (54% female), 17,836 were diagnosed with asthma during over 10 years of follow-up.
Compared with those deemed to be a low genetic risk, the hazard ratio (HR) for those with the highest genetic risk was 1.47 (95% CI 1.41 – 1.52) for the development of asthma. Similarly, among those with poor sleep, there was also an elevated risk for asthma (HR = 1.55, 95% CI 1.45 – 1.65). In addition, among those with a high genetic risk and categorised as having poor sleep, there was a more than two-fold increased risk of developing asthma (HR = 2.22, 95% CI 1.97 – 2.49, p < 0.001).
However, in further analysis, researchers found that a healthy sleep pattern was associated with a lower risk of asthma in all three genetic susceptibility groups. For example, a healthy sleep pattern reduced the risk of developing asthma by 44% (HR = 0.56) among those at a low genetic risk and by 37% in those at high genetic risk (HR = 0.63). In fact, the researchers calculated that at the population level, a low genetic risk and a healthy sleep pattern could reduce the risk of asthma cases by up to 19%.
The authors concluded that a healthy sleep pattern reflected a lower risk of asthma in adult populations and could be beneficial to asthma prevention regardless of genetic conditions.
Xiang B et al. Highlighting the importance of healthy sleep patterns in the risk of adult asthma under the combined effects of genetic susceptibility: a large-scale prospective cohort study of 455 405 participants. BMJ Open Respir Res 2023