Poor Sleep Quality and Outdoor Activity Increase Risk of Asthma and Allergic Rhinitis, finds study

A recent large-scale study published in the recent issue of Journal of Asthma and Allergy revealed significant insights into the combined effects of sleep quality and outdoor activity on childhood asthma and allergic rhinitis. 

The research involved a total of 16,936 children from kindergartens and primary schools across 13 administrative districts in Shanghai and employed the Children’s Sleep Habits Questionnaire (CSHQ) and the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The findings suggest that poor sleep quality and limited outdoor activity independently increased the risk of these respiratory and allergic conditions. However, the risk surged when both factors were present simultaneously.

The study reported a 10.2% prevalence of asthma and a 17.6% prevalence of allergic rhinitis among the surveyed children. An in-depth analysis revealed that poor sleep quality was associated with a 45% higher risk of asthma and a 16% higher risk of allergic rhinitis. Also, children with lower levels of outdoor activity had a 30% higher risk of asthma and an 18% higher risk of allergic rhinitis.

When poor sleep quality and low outdoor activity levels were combined, the risks increased even further which showed a 76% higher risk of asthma and a 46% higher risk of allergic rhinitis.

The study found that these associations were independent of sleep duration. This indicates that even children who slept for an adequate number of hours faced higher risks if their sleep quality was poor or if they lacked sufficient outdoor activity. The effects were more pronounced in children who had sufficient sleep duration but still experienced poor sleep quality.

Further stratified analysis considering gender, premature birth, and family history of allergies confirmed the findings across different groups, underscoring the robustness of the results. This research highlighted the importance of addressing multiple lifestyle factors simultaneously to reduce the risk of allergic diseases.

Parents and public health officials need to prioritize both improving children’s sleep quality and promoting adequate outdoor activity. Overall, this study serves as a reminder that merely meeting sleep duration recommendations is not enough. Ensuring good sleep quality combined with regular outdoor activity can play a significant role in preventing asthma and allergic rhinitis in children.

Reference:

Lu, R., Zhang, Y., Chen, Y., Lyu, J., Li, R., Kang, W., Zhao, A., Ning, Z., Hu, Y., Lin, X., Tong, S., Lu, Z., & Li, S. (2025). The joint association of sleep quality and outdoor activity with asthma and allergic rhinitis in children: A cross-sectional study in shanghai. Journal of Asthma and Allergy, 18, 101–111. https://doi.org/10.2147/jaa.s494662