Rationate: Sleep disorders (SD) are frequent in patients with asthma and constitute a treatable trait to consider when assessing patients with severe asthma, since the vicious cycle between the two pathologies amplifies and destabilizes the pathologies taken individually. To date, there are no consistent and sometimes conflicting data. Furthermore there are no certain data about the prevalence of SD in asthma.

Aim: to assess the prevalence and the burden of SD in patients affected by severe asthma enrolled in SANI registry.

Methods: this is a retrospective analysis of data collected in the SANI registry.

Results: of 2042 patients in the registry, 219 were excluded because sleep data were not available. Of the 1823 patients included, 1343 had no SD, 475 had SD with snoring (374) and OSA (101). Patients with SD are mainly men (45% vs 35.6%, p<0.001) and overweight (mean BMI: 27.3 vs 25.2, p<0.001). Rhinitis is the most frequently associated comorbidity (64.8% vs 48.8%, p<0.001), especially persistent moderate/severe entity (53.6% vs 32.5% p<0.001), with nasal polyposis (56.2% vs 41.3% p<0.001). These patients, although functionally less severe (FEV1 77.4% vs 73.9% p=0.014), have worse asthma control (ACT 16.8 vs 18, p<0.001 and AQLQ 4.3 vs 4.7, p<0.001), with a higher number of unplanned visits (40.5% vs 26%, p<0.001), more exacerbations requiring oral steroid therapy (2 vs 1, p=0.002) or already on oral steroid therapy (26.1% vs 17.8%, p<0.001).

Conclusions: the prevalence of sleep-disorders in the SANI registry is 26%. This cohort of patients had also moderate to severe rhinitis with nasal polyposis and functionally more stable but clinically more compromised asthma.