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Nocturnal wheeze measurement in preschool children
Jacobien B Eising1, Cuno S P M Uiterwaal, Cornelis K van der Ent
1Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Insights
Nocturnal wheezing is common in young children, with nearly 50% experiencing sporadic night-time wheeze. Higher wheeze rates correlate with increased respiratory resistance but not with reported wheezing symptoms.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Sleep Medicine
Background:
- Wheezing is a prevalent symptom in preschool-aged children.
- Nocturnal wheezing is often linked to asthma and exacerbated by overnight airflow limitations.
Purpose of the Study:
- To determine the prevalence of nocturnal wheezing in young children.
- To correlate nocturnal wheezing with respiratory system resistance and a history of wheezing symptoms.
Main Methods:
- Continuous overnight respiratory sound recordings were used to analyze wheeze rate, oxygen saturation, and heart rate in 59 three-year-olds.
- Wheeze rate was defined as the ratio of wheezing time to total breathing time.
- Nocturnal measurements were associated with prior wheezing history and respiratory system resistance (Rint).
Main Results:
- Analysis of wheeze rate was successful in 44 children, revealing a generally low overall rate.
- 21 out of 44 children (47.7%) exhibited a wheeze rate of ≥ 5% for at least one minute.
- No significant difference in wheeze rate was found between children with and without a history of wheezing.
- Tracheal sensor measurements of wheeze rate showed a significant correlation with respiratory system resistance (Rint).
Conclusions:
- The overall nocturnal wheeze rate in young children is low but may increase overnight.
- Nearly 50% of children experience sporadic nocturnal wheezing.
- Elevated nocturnal wheeze rates are associated with increased respiratory system resistance but not with clinically reported wheezing symptoms.
Rationale:
Wheezing is a very common symptom in preschool children. Nocturnal wheezing is present in many asthmatic patients, due to enhanced airflow limitation overnight. We assessed the prevalence of nocturnal wheezing in young children and correlated this with respiratory system resistance and history of wheezing symptoms.
Methods:
Using a continuous overnight recording of respiratory sounds we analyzed wheeze rate (ratio between wheezing time and recorded breathing time), oxygen saturation and heart rate during one night in 59 three-year-old children of an ongoing birth cohort study, the WHISTLER-project. We associated the nocturnal measurements with the patient's history of wheezing symptoms and with measurement of respiratory system resistance (Rint).
Results:
Analysis of wheeze rate was successful in 44 children. The overall wheeze rate of these children was low, with the highest wheeze rate of 0.63% measured by the tracheal sensor during expiration. In total, 21/44 children had a wheeze rate of ≥ 5% during at least 1 min. There was no statistically significant difference in wheeze rate between the children with and without a history of wheezing. The wheeze rate of the tracheal sensor had a significant correlation with Rint (correlation coefficients of inspiration and expiration: 0.308 and 0.382, P-values 0.05 and 0.01, respectively).
Conclusions:
Overall, the wheeze rate in young children is low, but seems to increase over nighttime. Almost 50% of the children have sporadic wheeze during the night. Although higher nocturnal wheeze rates are related to increased respiratory system resistance, it is not related to clinical wheezing symptoms.
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