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[Sleep disorders in childhood and adolescence, with special reference to allergic diseases]
Jolanta Wasilewska1, Maciej Kaczmarski, Piotr T Protas
1Department of Pediatrics, Gastroenterology and Allergic Diseases, Medical University of Bialystok, Poland. jolanta@umwb.edu.pl
Insights
Children with allergic diseases experience significant sleep disturbances, including difficulty falling asleep and disrupted sleep. Physicians should assess sleep quality in allergic children, as poor sleep is often unreported.
Area of Science:
- Pediatric Sleep Medicine
- Allergology
- Clinical Research
Context:
- Allergic diseases significantly impair children's quality of life.
- Sleep disturbances are common but often overlooked in pediatric allergic conditions.
Purpose:
- To compare sleep parameters between allergic and non-allergic children.
- To identify specific allergic conditions associated with sleep problems.
Summary:
- Allergic children took longer to fall asleep and had more disrupted sleep than controls.
- Atopic dermatitis and food allergy were most strongly linked to sleep difficulties.
- Snoring was significantly more prevalent in allergic children, particularly those with asthma or recurrent respiratory infections.
Impact:
- Allergic diseases are associated with various sleep disorders, including dyssomnias and parasomnias.
- Physicians must prioritize evaluating sleep quality in children with allergic conditions, regardless of the affected system.
- Increased awareness can lead to better management of sleep issues in allergic pediatric populations.
Unlabelled:
Allergic diseases have a significant impact on the quality of life. The aim of the study was to compare sleep parameters of allergic and non-allergic children.
Material And Methods:
Pediatric Sleep Questionnaire was used to asses sleep quality in 202 participants in a 3-year prospective study: in 122 hospitalized (mean age 7.9 +/- 4.7) (F/M 75/47) due to allergic (n = 70) or non-allergic disease (n = 52), and in 80 healthy children (mean age 6.3 +/- 5.0) (F/M 36/44). Of 70 allergic participants, 26 had atopic dermatitis (SCORAD > or = 20); 25 were with bronchial asthma (GINA' criteria) and 19 with IgE-dependent food allergy confirmed by oral food challenge. Of 52 non-allergic patients, 31 children had gastro-esophageal reflux disease and 21 children had recurrent respiratory infection.
Results:
The group of patients needed significantly more time to fall asleep than controls (17.9 +/- 13.7 vs 12.8 +/- 8.5 min; p < 0.004). Children with food allergy and atopic dermatitis had greatest problems with falling asleep (21.4 +/- 13.8 vs 12.8 +/- 8.5 min; p < 0.006) and 20.4 +/- 14.9 vs 12.8 +/- 8.5 min; p < 0.024). The number of nights of sound sleep without waking up was lower in the study group than in controls (3.5 +/- 2.6 vs 5.0 +/- 2.7; p < 0.0002). Atopic dermatitis and food allergy were found to predispose to sleep disruption most. Snoring history was revealed in 43.4% of patients and in 6.4% of controls (p < 0.0001), being significantly more common in children with bronchial asthma and recurrent respiratory tract infections. Allergic disease was a risk factor for snoring (OR--2.94; 95%CI--1.72-5.05; p < 0.001). As many as 91% of parents did not inform doctors about poor sleep of their children.
Conclusions:
1. Allergic diseases are accompanied by different sleep disorders included dyssomnias and parasomnias, e.g. bedtime resistance, disrupted sleep or sleep-disordered breathing. 2. Physicians should pay particular attention to sleep quality in children with allergic diseases irrespective of which body system is affected i.e. the skin (atopic dermatitis), the respiratory tract (bronchial asthma) or the alimentary system (food allergy).
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