New York: For hundreds of years, people have noticed that the severity of asthma often worsens at night. Researchers attribute the effect to the circadian system and not sleep and physical activity as traditionally thought.
75 percent of people with asthma experienced a worsening of asthma severity at night. Several behavioral and environmental factors, including exercise, air temperature, posture and sleep environment, are known to influence asthma severity.
In the study, the team from Brigham and Women’s Hospital and the University of Oregon Health and Science sought to understand the contribution of the internal circadian system to this problem.
The circadian system is composed of a central pacemaker (the suprachiasmatic nucleus) in the brain and “clocks” throughout the body and is important for coordinating bodily functions and for anticipating daily cycling environmental and behavioral demands.
“This is one of the first studies to separate the influence of the circadian system from other factors that are behavioral and environmental, including sleep,” said Frank AJL Scheer, director of the Medical Chronobiology Program in the Division of Sleep and Circadian Disorders. in Brigham.
“We observed that those who had the worst asthma suffered from the greatest circadian-induced drops in pulmonary function at night, and also had the greatest behavioral-induced changes, including sleep,” said Steven A. Shea, professor and director at the Oregon Institute of Occupational Health Sciences.
The findings are published in The Proceedings of the National Academy of Sciences.
To understand the effect of the circadian system, the team enrolled 17 participants with asthma (who were not on steroid medication, but used bronchodilator inhalers whenever they felt asthma symptoms worsening). In two complementary laboratory protocols where lung function, asthma symptoms and bronchodilator use were continuously assessed.
In the “continuous routine” protocol, participants spent 38 consecutive hours awake, in a stationary posture, and under dim lighting conditions, with identical snacks every two hours.
In the “forced inheritance” protocol, participants were placed on a recurrent 28-h sleep/wake cycle for one week under dim light conditions, with all behaviors determined equally throughout the cycle.
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