Asthma and COPD overlap (ACO) is related to a high burden of sleep disturbance and respiratory symptoms: Results from the RHINE and Swedish GA2LEN surveys

PLoS One. 2018 Apr 2;13(4):e0195055. doi: 10.1371/journal.pone.0195055. eCollection 2018.

Abstract

Background: The term Asthma and COPD Overlap (ACO) describes a condition where asthma and COPD overlap. We aimed to investigate associations between ACO and insomnia and respiratory symptoms, and to investigate the prevalence of ACO and the characteristics of subjects with ACO in two Northern European population studies.

Methods: The study comprised 25 429 subjects aged ≥ 40 years who participated in one of two Northern European general population surveys. Both surveys included questions on asthma, COPD, respiratory and sleep-related symptoms, including difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, and excessive daytime sleepiness. ACO was defined as having both self-reported asthma and COPD.

Results: The prevalence of ACO was 1.0%. The group with ACO had a higher prevalence of both insomnia and respiratory symptoms than subjects with only asthma or COPD. Having ACO was independently associated with a 2-3 times higher probability of having sleep-related symptoms as compared with the group without asthma or COPD, after adjustment for age, sex, BMI, smoking history and educational level (adjusted odds ratio 2.14-3.36, 95% CI).

Conclusion: Subjects with ACO have a high prevalence of insomnia and respiratory symptoms. To our knowledge, this is the first study to assess the association between sleep-related symptoms and ACO.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asthma / complications*
  • Asthma / epidemiology
  • Cost of Illness*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Public Health Surveillance
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / etiology*
  • Sweden / epidemiology
  • Symptom Assessment

Grants and funding

The GA2LEN survey was financially supported by the EU Sixth Framework Programme for Research, contract no. FOOD-CT-2004-506378. The study was also financially supported by the Swedish Heart and Lung Foundation, the Swedish Asthma and Allergy Foundation and the Swedish Association against Heart and Lung Diseases. The Gothenburg part of the study was mainly funded by the VBG Group Centre for Asthma and Allergy Research. The RHINE study was funded by the Swedish Heart and Lung Foundation, the Swedish Association Against Asthma and Allergy, the Swedish Association against Heart and Lung Disease, the Swedish Council for Working Life and Social Research, the Bror Hjerpstedt Foundation, the Vårdal Foundation for Health Care and Allergic Research, the Faculty of. Health, Aarhus University, Denmark (Project No. 240008), the Wood Dust Foundation (Project No 444508795), the Danish Lung Association, the Norwegian Research Council (project 135773/330), the Norwegian Asthma and Allergy Association, the Icelandic Research Council and the Estonian Science Foundation (Grant No. 4350).