Assessment of the Ru-SATED Questionnaire for Evaluating Sleep Quality in Adults with Severe Asthma Using Biologics

Keywords

sleep quality - Asthma - OSA

Introduction: The Ru-SATED questionnaire is a practical tool for evaluating sleep quality. Despite its extensive validation, including in the Brazilian population, its use in individuals with severe asthma undergoing biological treatment is limited.

Objective: To determine the effectiveness of the Ru-SATED questionnaire in assessing the sleep quality of adults with severe asthma using biologics.

Methods: A cross-sectional study was conducted from March 2020 to July 2024. The local Ethics Committee approved the research project (#40853020.9.0000.5257). Severe asthma patients using biologics who completed the Ru-SATED instrument and underwent a home sleep apnea test were included. A ratio of 1:2 was used to compare the sample of severe asthma patients with a randomly selected control sample. Chronic insomnia was defined as experiencing at least one of the following nocturnal symptoms: difficulty falling asleep, difficulty staying asleep, or waking up earlier than expected, on at least 3 nights per week for a minimum of 3 months. The Insomnia Severity Index (ISI) was used to determine the severity of insomnia. Obstructive sleep apnea (OSA) diagnosis was based on the respiratory event index ≥ 5.0/h. Two-tailed statistical tests were performed using the chi-square test (categorical variables) and the Mann-Whitney test (continuous variables).

Results: The study included 129 individuals (43 with severe asthma and 86 controls). Patients with severe asthma had significantly lower Ru-SATED scores than controls: 7.0 points (interquartile range [IQR]: 5.0-9.0) versus 8.0 points (IQR: 6.0-10.0); p = 0.021. The prevalence of chronic insomnia was significantly higher in patients with severe asthma than in controls: 53.5% versus 38.4%; p = 0.030. Individuals with chronic insomnia had significantly lower Ru-SATED scores than those without chronic insomnia: 6.0 points (IQR: 5.0-8.0) versus 9.0 points (IQR: 7.0-10.0); p < 0.001. There was no significant difference in the ISI scores between patients with severe asthma and controls (p = 0.418). Prevalence of OSA was significantly higher in the control group than in severe asthma patients: 77.9% versus 58.1%; p = 0.024.

Conclusion: Compared to controls, severe asthma patients had poorer sleep quality as assessed by the Ru-SATED, in addition to a higher incidence of chronic insomnia and a lower prevalence of OSA. These findings suggest that their poorer sleep quality is associated with the presence of chronic insomnia rather than the occurrence of OSA.

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Publikationsverlauf

Artikel online veröffentlicht:
16. September 2025