Sleep Duration and Exhaled Nitric Oxide in Asthma and Health Adults Interview with:
Rauno Joks, MD

Associate Professor of Clinical Medicine
Chief, Division of Allergy & Immunology
Program Director, Allergy &Immunology Fellowship
SUNY Downstate Medical Center What is the background for this study? What are the main findings?

Response: There are circadian and circannular patterns to many diseases, including allergy and asthma. Humans spend roughly one-third of their lifetimes asleep. Your immune system never sleeps, but shifts its activity when you sleep.

It is known that asthma disease activity can be worse at night – the reasons for this are complex, and may involve changes in allergic responses.

We found, in a preliminary study of both adults with and without asthma, that longer duration of nighttime sleep was associated with lower levels of exhaled nitric oxide, a biomarker which is elevated in exhaled breath of those with allergic asthma. This may carry over into the afternoon as well, but the sample size was too small to fully conclude that. What should readers take away from your report?

Response: There are lower levels of nitric oxide in exhaled breath in the morning if one sleeps longer. For asthma patients, if their asthma was controlled, it might have allowed for a good night’s sleep, and this was also reflected in the lower level of nitric oxide biomarker. On the other hand, actually getting more sleep may have also allowed for a shift of the immune response to a more reparative phase, which may have resulted in lower nitric oxide levels. It is hard to tell – which came first? The chick or the egg – the asthma control or the sleep. The entire group also included non-asthmatics for this inverse relationship – so it may be a more generalized protective effect of sleep, but we can’t conclude that at this point. What recommendations do you have for future research as a result of this study?

Response: We are currently investigating mediators of inflammation which play a role during the sleep- wake cycle in patients with allergies and asthma. Thank you for your contribution to the community.


The Effect of Sleep Duration on Levels of Exhaled Nitric Oxide from Healthy Adults and those with Asthma
Yi Feng Chen, MD, Maja Nowakowski, PhD, Maria-Anna Vastardi, MD, Helen G. Durkin, PhD, Rauno Joks, MD, FAAAAI
Center for Allergy and Asthma Research at SUNY Downstate Medical Center, Brooklyn, NY
February 2017Volume 139, Issue 2, Supplement, Page AB199
Journal of Allergy and Clinical Immunology

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 7, 2017 by Marie Benz MD FAAD