Abstract

BackgroundSouth Korea has experienced problems regarding poor management of symptoms of asthma patients and remarkable increases in sleep disorders. However, few studies have investigated these issues. We examined the relationship between sleep disorders and mortality in asthma patients to suggest effective alternatives from a novel perspective.MethodsWe used data from the National Health Insurance Service (NHIS) National Sample Cohort 2004–2013, which included medical claims filed for 186,491 patients who were newly diagnosed with asthma during the study period. We performed survival analyses using a Cox proportional hazards model with time-dependent covariates to examine the relationship between sleep disorders and mortality in asthma patients.ResultsThere were 5179 (2.78%) patients who died during the study period. Sleep disorders in patients previously diagnosed with asthma were associated with a higher risk of mortality (hazard ratio [HR]: 1.451, 95% confidence interval [CI]: 1.253–1.681). In addition, significant interaction was found between sleep disorders and Charlson comorbidity index.ConclusionsOur findings suggest that an increased prevalence of sleep disorders in asthma patients increases the risk of mortality. Considering the worsening status of asthma management and the rapid growth of sleep disorders in South Korea, clinicians and health policymakers should work to develop interventions to address these issues.

Highlights

  • South Korea has experienced problems regarding poor management of symptoms of asthma patients and remarkable increases in sleep disorders

  • According to a World Health Organization (WHO) report, about 235 million people suffer from asthma worldwide, and it is especially severe for children in low- and middle-income countries [2]

  • We excluded patients diagnosed with a sleep disorder (ICD-10: G47) prior to the diagnosis of asthma to limit our investigation to the effect of sleep disorders on patients who had already experienced asthma

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Summary

Introduction

South Korea has experienced problems regarding poor management of symptoms of asthma patients and remarkable increases in sleep disorders. According to a World Health Organization (WHO) report, about 235 million people suffer from asthma worldwide, and it is especially severe for children in low- and middle-income countries [2]. To determine the optimal management of asthma patients, numerous previous studies have been conducted, revealing many risk factors related to worsening status of asthma patients including clinical, socioeconomic, seasonal, and environmental factors [3,4,5,6,7,8,9,10]. Concerns remain regarding the management of worsening asthma in South Korea. To solve the problems related to inappropriate management, the Health Insurance Review & Assessment service (HIRA) introduced

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