Nocturnal cough and sleep quality to assess asthma control and predict attacks
Abstract
Introduction: Objective markers for asthma, that can be measured without extra patient effort, could mitigate current shortcomings in asthma monitoring. We investigated whether smartphone-recorded nocturnal cough and sleep quality can be utilized for the detection of periods with uncontrolled asthma or meaningful changes in asthma control, and for the prediction of asthma attacks.
Methods: We analyzed questionnaire and sensor data of 79 adults with asthma. Data were collected in situ for 29 days by means of a smartphone. Sleep quality and nocturnal cough frequencies were measured every night with the Pittsburgh Sleep Quality Index and by manually annotating coughs from smartphone audio recordings. Primary endpoint was asthma control assessed with a weekly version of the Asthma Control Test. Secondary endpoint were self-reported asthma attacks.
Results: Mixed effects regression analyses showed that nocturnal cough and sleep quality were statistically significantly associated with asthma control on a between- and within-patient level (p < .05). Decision trees indicated that sleep quality was more useful for detecting weeks with uncontrolled asthma (balanced accuracy (BAC) 68% vs. 61%; Δ sensitivity -12%; Δ specificity -2%), while nocturnal cough better detected weeks with asthma control deteriorations (BAC 71% vs. 56%; Δ sensitivity 3%; Δ specificity -34%). Cut-offs using both markers predicted asthma attacks up to five days ahead with BACs between 70% and 75% (sensitivities 75%-88% and specificities 57%-72%).
Conclusion: Nocturnal cough and sleep quality have useful properties as markers for asthma control and seem to have prognostic value for the early detection of asthma attacks. Show more
Permanent link
https://doi.org/10.3929/ethz-b-000449616Publication status
publishedExternal links
Journal / series
Journal of Asthma and AllergyVolume
Pages / Article No.
Publisher
Dove Medical PressSubject
Asthma; Digital biomarker; Nocturnal cough; Sleep quality; Asthma control assessment; Asthma attack predictionOrganisational unit
03681 - Fleisch, Elgar / Fleisch, Elgar
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Is new version of: https://doi.org/10.3929/ethz-b-000442961
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