Abstract

Rationale: African American females (AAF) have high prevalence and poor outcomes for asthma. Overweight/obesity was found to increase the risk for asthma, and obstructive sleep apnea (OSA) has been reported to exacerbate asthma. It is unclear if the coexistence of overweight /obesity and sleep disturbances increase risk of asthma in this population. Objectives: Assess the effects of poor sleep characteristic on the relationship between overweight/obesity and asthma in a large nationally representative sample of AAF. Methods: Cross-sectional analysis of a stratified multistage probability sample of non-institutionalized AAF, 16 years of age and older, participating in the National Health and Nutrition Examination Surveys 2005-2006 and 2007-2008. Survey analyses (Taylor Series Linearization approach) and nested hierarchical logistical regression modeling was used to predict asthma Measurements: Self-reported asthma, BMI and waist circumference, poor sleep characteristics (short sleep time, insomnia, OSA, self-perception of sleep deprivation, sleep disturbance due to wheezing), demographics and co-morbidities. Results: Overweight/obesity was significantly associated with asthma (P<0.001), and poor sleep characteristics did not confound / modify this relationship. Sleep deprivation (P<0.01) and OSA symptoms (P<0.05) are significantly associated with asthma in fully adjusted models, and overweight/obesity does not confound or modify this relationship. All poor sleep characteristics were significantly associated with overweight/obesity. Conclusions: Asthmatic AAF have significantly higher prevalence of poor sleep characteristics compared to their non-asthmatic counterparts, suggests that this population might benefit from management directed at sleep-related symptoms and conditions. Additional research is required to understand the pathophysiological mechanisms responsible for the observed relationships.