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Murine Model of Allergen Induced Asthma
Published on: May 14, 2012
Allergic sensitization and objective measures of sleep in urban school-aged children with asthma
Cynthia A Esteban1, Robin S Everhart2, Sheryl J Kopel3
1Department of Pediatrics, Division of Allergy and Immunology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
Insights
Increased allergic sensitization in children with asthma is linked to poorer sleep quality, including less efficient sleep and more night awakenings. Objective sleep measures confirm this association in urban schoolchildren.
Area of Science:
- Pediatric Allergy and Immunology
- Sleep Medicine
- Environmental Health
Background:
- Allergic sensitization is a known contributor to childhood asthma morbidity and reduced lung function.
- Objective sleep assessments are lacking in studies of children with asthma, relying instead on subjective reports.
Purpose of the Study:
- To examine the relationship between allergic sensitization, objectively measured by allergy tests, and sleep outcomes in urban schoolchildren with persistent asthma.
- To assess how allergic sensitization impacts sleep efficiency, sleep duration, and the frequency of awakenings.
Main Methods:
- 196 children (7-9 years) with persistent asthma underwent allergy testing (skin prick test or specific IgE).
- Sleep outcomes were objectively measured using actigraphy over a one-month period.
- Pulmonary function (Forced Expiratory Volume in 1 second) was monitored at home.
Main Results:
- A higher number of positive allergy test results correlated with decreased sleep efficiency and increased night awakenings.
- Variability in lung function moderated the link between allergic sensitization and sleep efficiency variability.
- Significant racial and ethnic disparities were observed in allergic sensitization and sleep outcomes between African Americans and Latinos.
Conclusions:
- Objective data show that increased allergic sensitization is associated with poorer sleep in urban children with asthma.
- Findings suggest implications for targeted environmental controls and asthma management strategies, considering racial and ethnic differences.
Background:
Allergic sensitization is associated with increased child asthma morbidity and decreased pulmonary function. Nocturnal symptoms and/or awakenings typically are measured by self-report from diary data, whereas objective assessments of sleep in child asthma studies are lacking.
Objective:
To investigate the association between increased allergic sensitization (number of positive allergy test results measured by skin prick test or specific immunoglobulin E) and sleep outcomes (sleep efficiency, sleep duration, and mean number of awakenings measured by actigraphy) in urban schoolchildren with persistent asthma.
Methods:
One hundred ninety-six children with persistent asthma (7-9 years old) attending public school in 1 of 4 large urban school districts completed allergy testing during a study clinic visit. Forced expiratory volume in 1 second was monitored at home using a handheld spirometer. Sleep outcomes were measured with a wrist Actiwatch during a 1-month period in the fall and winter seasons.
Results:
Number of positive allergy test results significantly predicted mean sleep efficiency (P = .02), such that children with more positive test results experienced less efficient sleep. Number of positive allergy test results significantly predicted mean number of night awakenings (P = .05), such that children with more positive allergy test results experienced more night awakenings. Variability in forced expiratory volume in 1 second was a significant moderator in the association between number of positive allergy test results and variability in sleep efficiency (P = .04). Racial and ethnic differences in allergic sensitization and sleep outcomes were found between African Americans and Latinos.
Conclusion:
More positive allergy test results were associated with poorer sleep outcomes measured objectively in this sample of urban children. Implications for environmental control interventions and asthma treatments in different racial and ethnic groups are discussed.
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