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The frequency of sleep-disordered breathing in children with asthma and its effects on asthma control
Tayfur Ginis1, Fatih Alper Akcan2, Murat Capanoglu1
1a Department of Pediatric Allergy and Immunology , Ankara Children's Hematology Oncology Training and Research Hospital , Ankara , Turkey.
Insights
Sleep-disordered breathing (SDB) significantly increases the risk of poorly controlled asthma in children. Tonsillar hypertrophy may also contribute to this association, highlighting the importance of addressing SDB in pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Pediatric Allergy
Background:
- Sleep-disordered breathing (SDB) is increasingly recognized as a potential complicating factor in childhood asthma.
- Difficult-to-control asthma in children may be linked to the presence of SDB.
Purpose of the Study:
- To determine the prevalence of SDB in children diagnosed with asthma.
- To investigate the impact of SDB on asthma control levels.
- To identify risk factors associated with SDB in this pediatric population.
Main Methods:
- Utilized the Parents of children who Sleep Questionnaire (PSQ) and the Childhood Asthma Control Test (C-ACT) for data collection.
- Assessed asthma control using Global Initiative for Asthma (GINA) guidelines.
- Evaluated tonsil size using a 4-point grading scale and adenoid size via the adenoid-nasopharynx ratio by an ENT specialist.
Main Results:
- Out of 408 children (mean age 8.1 years), 34.6% exhibited SDB.
- Nearly 40% of children had not-well-controlled asthma.
- SDB (OR: 6.62) and tonsillar hypertrophy (OR: 3.47) were identified as independent risk factors for not-well-controlled asthma.
Conclusions:
- SDB is a significant, independent risk factor for poorly controlled asthma in children.
- Tonsillar hypertrophy may play a role in the relationship between SDB and suboptimal asthma control in pediatric patients.
Background:
The presence of sleep-disordered breathing (SDB) in children with asthma may cause difficult to control asthma.
Objectives:
The aim of this study was to determine the frequency of SDB in children with asthma, to evaluate its effects on asthma control and to assess the risk factors associated with the presence of SDB.
Methods:
Parents of children who Sleep Questionnaire (PSQ) and the Childhood Asthma Control Test (C-ACT). Asthma control level was assessed according to Global Initiative for Asthma (GINA). Same ear-nose-throat (ENT) specialist evaluated all patients. A 4-point tonsil grading method and adenoid-nasopharynx ratio were used to categorize tonsil and adenoid size, respectively.
Results:
A total of 408 children (275 male, 67.4%) with a mean age of 8.1 ± 3.2 years were included. Nearly 40% of asthmatic children were not-well-controlled according to GINA and 34.6% of all patients had SDB according to PSQ. Multivariate logistic regression analysis revealed that coexistence of SDB [OR: 6.62, 95% CI (4.21-10.41); p < 0.001)] and tonsillar hypertrophy [OR: 3.47; 95% CI (1.05-11.5); p < 0.041] were independent risk factors for not-well-controlled asthma in asthmatic children after other established contributors to asthma control were adjusted.
Conclusions:
Our study showed that SDB is a strong risk factor for not-well-controlled asthma in asthmatic children independent of other confounders. In addition, tonsillar hypertrophy may have a role in the association between SDB and not-well-controlled asthma in childhood.
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