Abstract
BACKGROUND: Circadian preference for eveningness has been linked to a higher risk of asthma and allergies, but its association with health-related quality of life (HRQL) in asthma has not been studied yet. OBJECTIVE: We aimed to investigate the associations between individual circadian preference and HRQL in asthma. METHODS: Among 691 adult asthma patients from Canada, India, New Zealand, and the United Kingdom, a digital questionnaire was administered to capture demographic information, social and psychologic attributes, comorbidities, and medication adherence. Circadian preference and HRQL were assessed by the reduced version of the morningness-eveningness questionnaire (rMEQ) and the short form of the chronic respiratory questionnaire, respectively. We analyzed the association between chronotype and HRQL using mixed-effect linear regression models. RESULTS: Of all participants, 59% were female with a mean (standard deviation) age of 49 (17) years. Median (interquartile range) rMEQ total score was 17 (14-19). Mean (standard deviation) dyspnea, fatigue, emotional function, and mastery scores were 5.94 (1.2), 4.38 (1.3), 5.05 (1.3), and 1.96 (1.1), respectively. In regression analysis, a higher rMEQ total score (higher morningness) was associated with less fatigue (β = 0.06; 95% confidence interval, 0.04 to 0.09) and better emotional function (β = 0.03; 95% confidence interval, 0.004 to 0.06), and these associations were mediated by less anxiety, depression, and alcohol abuse, and better sleep quality. CONCLUSION: Morning orientation is associated with better HRQL in patients with asthma. The results suggest that working with patients to promote schedules and habits related to morningness may be beneficial.