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Development of atopic disease and disturbed sleep in childhood and adolescence--a longitudinal population-based study
S Jernelöv1, M Lekander, C Almqvist
1Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Susanna.jernelov@ki.se
Insights
Childhood overtiredness and asthma symptoms may influence each other over time. This suggests a potential bidirectional relationship between atopic disease and sleep disturbances in children.
Area of Science:
- Pediatric Allergy and Immunology
- Developmental Psychology
- Sleep Medicine
Background:
- Rising prevalence of atopic diseases and sleep disturbances in children.
- Sleep's crucial role in immune regulation relevant to allergic conditions.
- Established link between sleep issues, fatigue, and atopic disease, but causal pathways remain unclear.
Purpose of the Study:
- Investigate developmental relationships between sleep disturbances and atopic disease symptoms.
- Examine the time course of these conditions from childhood to adolescence.
Main Methods:
- Longitudinal study using parent-reported data from the Twin Study of Child and Adolescent Development (TCHAD).
- Data collected from 1480 twin pairs at ages 8-9 and 13-14.
- Linked TCHAD data with the Swedish Medical Birth Register.
Main Results:
- Overtiredness at age 8 increased risk of rhinitis at age 13 (OR 2.59).
- Asthma symptoms at age 8 independently predicted overtiredness at age 13 (OR 2.64).
- These associations remained significant after controlling for confounders.
Conclusions:
- Findings support a more than passive interrelation between atopic disease and disturbed sleep.
- Further research is needed to confirm causal relationships and developmental timing.
- Clinicians should assess and treat sleep difficulties in pediatric patients with atopic conditions.
Background:
Both atopic diseases and sleep disturbances have increased during recent decades, especially in children. Sleep is important for many aspects of immune regulation relevant in allergic diseases, and sleep disturbances are common in patients with such diseases. A connection between sleep disturbances and fatigue, and atopic disease is well established. However, the time course and putative causal relationships between these factors are obscure.
Objective:
We aimed at investigating the developmental relationships between subjectively reported sleep disturbances and symptoms of atopic disease, from childhood to adolescence.
Methods:
This longitudinal study used parent-report questionnaire data on symptoms of atopic disease, and sleep disturbances, from the Twin Study of Child and Adolescent Development (TCHAD). Overall, 1480 twin pairs born in Sweden were approached first when children were 8-9 years old, and again later at 13-14 years old. Response rates were 75% and 72%. Data from the TCHAD questionnaires were linked to the Swedish Medical Birth Register based on personal identification numbers.
Results:
Being overtired at age 8 increased the risk [OR; 95% CI (2.59; 1.31-5.11)] to develop rhinitis symptoms at age 13, even when controlling for gender, previous rhinitis, Socio-economic status, birth weight and other sleep disturbances at age 8. Likewise, symptoms of asthma at age 8 was an independent risk factor for being overtired at age 13 [OR; 95% CI (2.64; 1.44-4.84)], controlling for similar confounders.
Conclusion & Clinical Relevance:
The findings from this study are consonant with the proposition that atopic disease and disturbed sleep are more than passively interrelated. Future research needs to delineate whether causal relationships between these problems are at hand and, if so, at what periods in development this applies. These results point to a need for clinicians to investigate sleep difficulties and treat impaired sleep in paediatric patients with atopic disease.
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