ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1646053
The Impact of Sleep Quality on Asthma Incidence in Middle-Aged and Older Adults: Evidence from a Prospective Cohort Study
Provisionally accepted
- Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, China
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Background: Sleep disorders represent a growing public health burden, while asthma persists as a predominant chronic respiratory condition globally. Although suboptimal sleep quality correlates with diverse adverse health outcomes, its prospective association with asthma incidence in middle-aged and older adults remains inadequately characterized. Methods: Utilizing data from the English Longitudinal Study of Ageing (ELSA), this cohort study included 4,578 asthma-free participants aged ≥50 years at baseline. Baseline sleep quality was quantified via a validated questionnaire, classifying participants into high, moderate, and low quality strata; nocturnal sleep duration was concurrently assessed. Incident asthma diagnoses over a 10-year follow-up period constituted the primary endpoint. Multivariable Cox proportional hazards regression models estimated hazard ratios (HRs) for asthma risk, adjusting for demographic, lifestyle, and comorbidity covariates. Results: Among 4,578 participants, 156 incident asthma cases (3.41%) emerged during follow-up. Following comprehensive adjustment, baseline sleep quality demonstrated a significant dose-response relationship with asthma risk (P for trend < 0.001). Relative to the high-quality reference group, moderate- and low-quality groups exhibited 63% (HR = 1.63; 95% CI: 1.09–2.42) and 84% (HR = 1.84; 95% CI: 1.16–2.92) elevations in asthma risk, respectively. No statistically significant association emerged between sleep duration and asthma incidence. Conclusion: This large-scale prospective cohort study demonstrates that poor sleep quality is an independent risk factor for the development of asthma in middle-aged and older adults, independent of sleep duration. The findings highlight the potential importance of optimizing sleep quality (rather than simply extending sleep duration) in asthma primary prevention. Improving sleep quality may represent a novel intervention target to reduce asthma incidence in this population and provide evidence for public health strategies.
Keywords: sleep quality, sleep duration, Asthma, English Longitudinal Study of Ageing (ELSA), middleaged and older adults
Received: 17 Jun 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Yu, Chen and Zou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lamei Zou, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, China
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