Associations of insomnia with lung function and mortality among asthma patients and the mediating roles of inflammatory biomarkers: a population-based cohort study

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-09-15 DOI:10.1016/j.cegh.2025.102184

Xiaoxiao Jiang , Yongqi Liang , Jinming Zhang , Shiya Liang , Dongyu Liu , Yuhan Du , Jie Chen , Yanqun Li , Liping Huang , Qi Yu , Tiantian Liu , Yimei Gao , Jinzhong Zhuo , Haohua Huang , Shaoxi Cai , Xianbo Wu , Hangming Dong

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引用次数: 0

Abstract

Objectives

Insomnia often leads to systemic chronic inflammation and is particularly common among asthma patients. However, the specific impact of insomnia on lung function and mortality in asthma patients remains unclear. This study aims to investigate the relationship between insomnia, lung function, and mortality in asthma patients, and further elucidate the potential role of inflammatory biomarkers in this association.

Study design

This was a prospective cohort study.

Methods

This prospective cohort study using data from the UK Biobank included 37250 participants with asthma. Multiple linear regression and Cox proportional hazards models were separately used to explore the relationships between insomnia, lung function, and mortality. Mediation analysis assessed the mediating effects of inflammatory biomarkers.

Results

Compared to those without insomnia, frequent insomnia was associated with a 0.06 decline in FEV1 (Z-score) and a 0.11 reduction in FEV1/FVC (Z-score). The Hazard ratios (HRs) for individuals with frequent insomnia were 1.10 (95 % CI: 1.01–1.19) for all-cause mortality and 1.15 (95 % CI: 1.02–1.29) for cancer-related mortality. Inflammatory biomarkers mediated the association between insomnia and mortality, proportions(%) were WBC (5.86), NEU (11.9), SII (5.71), LCR (15.3) and CRP (13.8).

Conclusion

Insomnia in asthma patients is negatively associated with lung function and increases the risks of both all-cause and cancer-related mortality. Inflammatory biomarkers partially mediate this association.

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失眠与哮喘患者肺功能和死亡率的关联以及炎症生物标志物的中介作用：一项基于人群的队列研究

目的失眠常导致全身性慢性炎症，在哮喘患者中尤为常见。然而，失眠对哮喘患者肺功能和死亡率的具体影响尚不清楚。本研究旨在探讨哮喘患者失眠、肺功能和死亡率之间的关系，并进一步阐明炎症生物标志物在这种关联中的潜在作用。研究设计：这是一项前瞻性队列研究。方法：这项前瞻性队列研究使用来自英国生物银行的数据，纳入了37250名哮喘患者。分别采用多元线性回归和Cox比例风险模型探讨失眠、肺功能和死亡率之间的关系。中介分析评估炎症生物标志物的中介作用。结果与无失眠症患者相比，频繁失眠患者FEV1 （Z-score）下降0.06,FEV1/FVC （Z-score）下降0.11。频繁失眠症患者的全因死亡率风险比为1.10 (95% CI: 1.01-1.19)，癌症相关死亡率风险比为1.15 （95% CI: 1.02-1.29）。炎症生物标志物介导失眠与死亡率之间的关联，比例（%）为WBC（5.86）、NEU（11.9）、SII（5.71）、LCR（15.3）和CRP（13.8）。结论哮喘患者失眠与肺功能呈负相关，并增加全因死亡率和癌症相关死亡率。炎症生物标志物部分介导了这种关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.