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The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects
Nira A Goldstein1,2, Charlotte Aronin1,2, Beth Kantrowitz1,2
1Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York.
Insights
Children with asthma have a higher prevalence of sleep-disordered breathing (SDB), which worsens with asthma severity. SDB, not asthma, independently predicts behavioral problems in children.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Child Psychology
Background:
- Asthma is a common chronic respiratory condition in children.
- Sleep-disordered breathing (SDB) is increasingly recognized as a comorbidity in pediatric populations.
- The relationship between asthma, SDB, and behavioral issues in children requires further investigation.
Purpose of the Study:
- To compare the prevalence of SDB in children with and without asthma.
- To assess the association between asthma severity and SDB.
- To determine if SDB or asthma independently predicts behavioral problems.
Main Methods:
- Cross-sectional study design.
- Involved 263 children with asthma and 266 controls (ages 2-15).
- Utilized the Pediatric Sleep Questionnaire (PSQ) and Child Behavior Checklist; asthma severity classified by NIH guidelines.
Main Results:
- Asthmatic children showed significantly higher prevalence of snoring (35.5% vs. 15.7%) and positive PSQ (25.9% vs. 10.6%).
- SDB prevalence increased with asthma severity.
- SDB, socioeconomic status, and age were independent predictors of behavioral problems, while asthma was not.
Conclusions:
- Asthma is associated with a higher prevalence of SDB in children.
- SDB, independent of asthma, is a significant predictor of behavioral problems.
- Findings highlight the importance of screening for SDB in children with asthma.
Objectives:
To determine the prevalence of sleep-disordered breathing (SDB) in children with asthma compared to non-asthmatic children and to determine if behavior problems are associated with asthma and SDB.
Study Design:
Cross-Sectional.
Methods:
Parents of 263 children with asthma and 266 controls ages 2 to 15 years attending routine pediatric office visits completed the Pediatric Sleep Questionnaire (PSQ) and the Child Behavior Checklist. Asthma severity was classified based on NIH guidelines.
Results:
The prevalence of snoring was significantly higher in asthmatic children (35.5%) than controls (15.7%) and the prevalence of a positive PSQ was significantly higher in asthmatic children (25.9%) than controls (10.6%) (P < 0.001 for both). The effect of asthma was "dose-dependent" as children with more severe asthma had increased odds ratios for snoring and a positive PSQ. On multivariate analysis, there were significant interactions of gender with asthma and age with gender. A positive modified PSQ along with measures of socioeconomic status and age were the only independent predictors of abnormal Child Behavior Checklist scores and score classifications.
Conclusions:
There was a higher prevalence of SDB in asthmatic children compared to non-asthmatic children and the prevalence of SDB increased with increasing asthma severity. In multivariate analysis the role of asthma was much less clear as it predicted a positive PSQ in girls but not boys. SDB, but not asthma, was an independent predictor of behavioral problems.
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