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Asthma and allergies more common in teens who stay up late

They found that the chance of having asthma was around three times higher in teens who prefer to sleep later compared to those who preferred to sleep earlier. They also found the risk of suffering allergic rhinitis was twice as high in late-sleepers compared to early-sleepers.

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Teenagers who prefer to stay up late and wake later in the morning are more likely to suffer with asthma and allergies compared to those who sleep and wake earlier, according to a study published in ERJ Open Research.

Asthma symptoms are known to be strongly linked to the body’s internal clock, but this is the first study to look at how individual sleep preferences influence asthma risk in teenagers.

Researchers say the study reinforces the importance of sleep timing for teenagers and opens up a new channel of research in to how sleep affects teenagers’ respiratory health.

The study was led by Dr. Subhabrata Moitra from the division of pulmonary medicine at the University of Alberta, Canada, who carried out the research while at the Barcelona Institute for Global Health, Spain. He said: “Asthma and allergic diseases are common in children and adolescents across the world and the prevalence is increasing. We know some of the reasons for this increase, such as exposure to pollution and tobacco smoke, but we still need to find out more.

“Sleep and the ‘sleep hormone’ melatonin are known to influence asthma, so we wanted to see if adolescents’ preference for staying up late or going to bed early could be involved in their asthma risk.”

The study involved 1,684 adolescents living in West Bengal, India, aged 13 or 14 years, who were taking part in the Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study.

Each participant was asked about any wheezing, asthma, or symptoms of allergic rhinitis, such as a runny nose and sneezing. They were asked a series of questions to judge whether they were ‘evening types’, ‘morning types’ or in between, such as what time of the evening or night they tend to feel tired, when they would choose to wake up, and how tired they feel first thing in the morning.

Researchers compared the teenagers’ symptoms with their sleep preferences, taking into account other factors that are known to affects asthma and allergies, such as where the participants live and whether their family members smoke.

They found that the chance of having asthma was around three times higher in teens who prefer to sleep later compared to those who preferred to sleep earlier. They also found the risk of suffering allergic rhinitis was twice as high in late-sleepers compared to early-sleepers.

Moitra adds: “Our results suggest there’s a link between preferred sleep time, and asthma and allergies in teenagers. We can’t be certain that staying up late is causing asthma, but we know that the sleep hormone melatonin is often out of sync in late-sleepers and that could, in turn, be influencing teenagers allergic response.

“We also know that children and young people are increasingly exposed to the light from mobile phone, tablets, and other devices, and staying up later at night. It could be that encouraging teenagers to put down their devices and get to bed a little earlier would help decrease the risk of asthma and allergies. That’s something that we need to study more.”

A second phase of the PERFORMANCE study is scheduled in 2028-29, which means it will be possible to repeat the study with a new group of teenagers to see if there has been any change in teenagers sleeping habits and their respiratory health. Dr Moitra and his team also hope to quantify their findings by taking objective measurements of participants’ lung function and sleep time.

Professor Thierry Troosters is President of the European Respiratory Society and was not involved in the research. He said: “We need to know much more about why asthma and allergies are rising in children and teenager and, hopefully, find ways to reduce these conditions.

“This is the first study to examine the possible role of different sleep preferences in teenagers’ risk of asthma and allergies, and it opens up an interesting and important new line of research. We already know that sleeping well is important for physical and mental health, so we should continue to encourage teenagers to get a good night’s sleep.”

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Gene therapy has potential to cure thalassemia patients from blood disorder

Thalassemia is a blood disorder that affects the body’s ability to produce red blood cells, and hemoglobin, the protein that carries oxygen in red blood cells. Even with blood transfusion and appropriate iron chelation therapy; patients can develop iron overload, with potential to damage the liver, heart, and endocrine system.

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Gene therapy could pave the way for patients with the inherited blood disorder thalassemia to stop or significantly reduce blood transfusions and transform their daily lives, says an expert at a top American hospital, Cleveland Clinic.

Dr. Rabi Hanna, a pediatric hematologist-oncologist, said: “Thalassemia is a disease that can be cured, with gene therapy as a novel step that uses the patients’ own hematopoietic stem cells to produce healthier red blood cells and fix their blood disorder. Thalassemia patients who have received gene therapy have either eliminated or significantly reduced the amount of blood transfusions needed to manage their condition. With gene therapy, we can remove the challenges that thalassemia patients face to give them the courage to pursue their goals and dreams, whether in education, careers, or families.”

Thalassemia is a blood disorder that affects the body’s ability to produce red blood cells, and hemoglobin, the protein that carries oxygen in red blood cells. Even with blood transfusion and appropriate iron chelation therapy; patients can develop iron overload, with potential to damage the liver, heart, and endocrine system.

There are two type of thalassemia, alpha and beta, depending on the defects that can occur in the protein chains that make up hemoglobin. Patients with alpha thalassemia tend to be silent carriers without symptoms, while patients with beta thalassemia major will have major symptoms early after birth and require frequent red blood transfusions. Moderate and severe thalassemia cases are usually diagnosed with early childhood blood tests. Married couples can also have genetic tests that can predict the risk of thalassemia and related blood disorders.

Worldwide, there are 270 million carriers with abnormal hemoglobin and thalassemia, with 300,000-400,000 babies born with serious hemoglobin disorders annually, according to the US National Institute of Health. It is estimated that 90 percent of those births are in low- or middle-income countries, especially in the Middle East, South and Southeast Asia, the Mediterranean, Africa, and the South Pacific. Recognizing this, International Thalassemia Day’s theme for 2021 is “Addressing Health Inequalities Across the Global Thalassemia Community.”

In contrast to time-consuming, life-long blood transfusions, gene therapy could be a one-time therapy and provide a potential cure. Despite that, the allogeneic bone marrow transplant is currently the only available option with the potential to correct the genetic deficiency in Transfusion-dependent Thalassemia (TDT), but it has possible complications such as graft failure, graft-versus-host disease (GvHD), and opportunistic infections, particularly in patients who undergo non-sibling matched allogeneic HSCT. Gene therapy, in contrast, uses the patient’s own cells and eliminates the risk of GVHD.

The challenge in Dr. Hann’s opinion is how we can make this therapy available worldwide, especially in developing countries, where most of the patients are, globally.

The European Medicines Agency has given conditional marketing authorization to one form of genetically modified products for beta-thalassemia. In the United States, there are currently clinical trials for gene therapy, and this therapy is under review by Food and Drug Administration – which experts hope could lead to authorization later in 2021.

In recent phase 1-2 studies of gene therapy for 22 patients, all of them had reduced or eliminated the need for long-term red blood cell transfusions. Of the 13 alpha-thalassemia patients, 12 stopped receiving red blood cell transfusions. For the nine beta-thalassemia patients, three stopped red blood cell transfusions, and the remaining six patients saw their median annualized transfusion volume decrease by 73 percent.

“While gene therapy is a promising cure for transfusion-dependent thalassemia, many patients do not know the whole process – including chemotherapy to get rid of the old bone marrow and create space for the new modified stem cells. This will currently require admission to hospital for four to 6 weeks until new the stem cells are working and able to produce white blood cells, platelets and healthier red blood cells,” added Dr. Hanna. “We are hopeful that in the future we can target the bone marrow more selectively using reduced intensity chemotherapy or other medication to avoid the acute and long-term toxicity associated with high doses of chemotherapy.”

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Asthma both under-diagnosed and misdiagnosed

Proper medical diagnosis of asthma could mean that about one-third of people assumed to suffer from the disease could be weaned off long-term medications, impacting millions of people worldwide, says an expert at a top American hospital, Cleveland Clinic.

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Proper medical diagnosis of asthma could mean that about one-third of people assumed to suffer from the disease could be weaned off long-term medications, impacting millions of people worldwide, says an expert at a top American hospital, Cleveland Clinic.

Dr. Joe Zein, who specializes in pulmonary medicine at Cleveland Clinic, said: “Asthma impacts millions of people, and proper diagnoses and treatment are vital to treat asthma early before any damage occurs to the airway. Studies show that one-third of patients thought to have asthma are misdiagnosed by doctors, and 15% of asthma patients taking medication long term do not have an objective diagnosis. Proper diagnosis can ensure that patients receive the right treatment, reduce triggers, and lead healthier lives.”

A study in the Journal of American Medicine (JAMA) found that 33% of randomly tested asthma patients could be safely weaned off their medications, and did not need long-term inhaled steroids.

Asthma is one of the world’s major chronic diseases, impacting more than 339 million people globally, and the most common, non-communicable disease among children, according to the World Health Organization. At the same time, studies have found that asthma is under-diagnosed and under-treated.

Commenting on World Asthma Day 2021’s theme of “Uncovering Asthma Misconceptions,” Dr. Zein emphasized that while some people assume otherwise, asthma tests are often quick and easy. Common diagnostic methods include a spirometry test that measures the airflow through the lungs, and a methacholine challenge test that evaluates how reactive lungs are to changes in the environment. Healthcare practitioners may also request chest x-rays, and blood, skin, or allergy tests.

Asthma patients can suffer from chest tightness, pain, or pressure; coughing; and shortness of breath or wheezing. An asthma attack restricts airflow due to tightened and inflamed airways, and mucus clogs.

Treatment can include anti-inflammatory medicines that make it easier for air to enter and exit the lungs, bronchodilators that relax the airway muscles, or biologic therapies that target specific molecules.

Asthma, which has both genetic and environmental causes, has a wide range of triggers – especially in people’s own homes and neighborhoods. The most common asthma triggers are dust mites, pet dander, pollen and ragweed, pests such as cockroaches and mice, and mold. Tobacco smoke from the patient themselves or from secondhand smoke, air pollution, and exercise can also all trigger asthma attacks.

“People with asthma may not want to get rid of their pets, especially cats or dogs,” added Dr. Zein. “If asthma patients have to keep their pets in the house, they should keep pets outside of the bedroom, and replace any thick carpets with tile or hardwood to reduce pet dander. Asthma patients should also wash their bedding with hot water, vacuum often to remove dust, and put in de-humidifiers in any damp areas of the house.”

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Does listening to calming music at bedtime actually help you sleep?

Listening to calming music at bedtime improved sleep quality in older adults, and calming music was much better at improving sleep quality than rhythmic music.

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A new study published in the Journal of the American Geriatrics Society has found that listening to music can help older adults sleep better.

Researchers from the National Cheng Kung University Hospital in Taiwan combined the results of past studies to understand the effect that listening to music can have on the quality of older adults’ sleep. Their work suggests that:

  • Older adults (ages 60 and up) living at home sleep better when they listen to music for 30 minutes to one hour at bedtime.
  • Calm music improves older adults’ sleep quality better than rhythmic music does.
  • Older adults should listen to music for more than four weeks to see the most benefit from listening to music.

Why Older Adults Have Trouble Getting a Good Night’s Sleep

As we age, our sleep cycles change and make a good night’s sleep harder to achieve. What does it really mean to get a good night’s sleep? If you wake up rested and ready to start your day, you probably slept deeply the night before. But if you’re tired during the day, need coffee to keep you going, or wake up several times during the night, you may not be getting the deep sleep you need. According to the National Institute on Aging, older adults need seven to nine hours of sleep each night.

But studies have shown that 40 to 70 percent of older adults have sleep problems and over 40 percent have insomnia, meaning they wake up often during the night or too early in the morning. Sleep problems can make you feel irritable and depressed, can cause memory problems, and can even lead to falls or accidents.

How the Researchers Studied the Effect of Music on Older Adults’ Quality of Sleep

For their study, the researchers searched for past studies that tested the effect of listening to music on older adults with sleep problems who live at home. They looked at five studies with 288 participants. Half of these people listened to music; the other half got the usual or no treatment for their sleep problems. People who were treated with music listened to either calming or rhythmic music for 30 minutes to one hour, over a period ranging from two days to three months. (Calming music has slow tempo of 60 to 80 beats per minute and a smooth melody, while rhythmic music is faster and louder.) All participants answered questions about how well they thought they were sleeping. Each participant ended up with a score between 0 and 21 for the quality of their sleep.

The researchers looked at the difference in average scores for:

  • people who listened to music compared to people who did not listen to music;
  • people who listened to calm music compared to people who listened to rhythmic music;
  • and people who listened to music for less than four weeks compared to people who listened to music for more than four weeks.

What the Researchers Learned

Listening to calming music at bedtime improved sleep quality in older adults, and calming music was much better at improving sleep quality than rhythmic music. The researchers said that calming music may improve sleep by slowing your heart rate and breathing, and lowering your blood pressure. This, in turn helps lower your levels of stress and anxiety.

Researchers also learned that listening to music for longer than four weeks is better at improving sleep quality than listening to music for a shorter length of time.

What this Study Means for You

If you’re having trouble sleeping, listening to music can be a safe, effective, and easy way to help you fall and stay asleep. It may also reduce your need for medication to help you sleep.

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