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Objective:  The aim of this study was to assess the association between morningness–eveningness and disease control with consideration of mental state as a mediator and the control of confounding factors among adult asthma patients. Methods:  This is a cross-sectional study, which included a nonrandom sample of  N  = 66 patients from an outpatient unit with a confirmed asthma diagnosis, who gave an informed consent and completed a set of questionnaires: a survey comprising questions about sociodemographic and clinical characteristics, the Asthma Control Test (ACT), the Composite Scale of Morningness (CSM), and the General Health Questionnaire (GHQ-28). Mediation models were created separately for each GHQ-28 dimension (somatic symptoms, anxiety/insomnia, social dysfunction and depressive symptoms), for a total score and for four GHQ-28 dimensions together, considered as mediators. Results:  Low morning affect was related to poor disease symptom control among patients with asthma. The effect was fully mediated by non-psychotic mental health indices. Evening-time preference was associated with a rise in asthma control, and mediated by somatic symptoms and anxiety/insomnia, when controlled for morning affect. Conclusions:  The current study underlines the significance of assessment of both individual morningness–eveningness preference and mental health in the management of asthma symptoms.

Mental health indices may fully mediate the relationship between morningness–eveningness and disease control among adult asthma patients