Wheeze sound characteristics are associated with nighttime sleep disturbances in younger children

Wheezing is a typical symptom of respiratory conditions. Few objective methods are available for predicting sleep disturbance in young children with wheezing.

We investigated whether wheezing characteristics, detected by lung-sound analysis, were associated with risk of sleep disturbance.

We recorded the lung sounds of 66 young children (4-59 months) every morning, for the entire duration of a wheezing episode. On lung-sound analysis, wheezing was displayed as horizontal bars of intensity with corresponding sharp peaks of power. The sharp peak of power was defined as a wheeze band. Wheezing characteristics (e.g., number, frequency, duration, and frequency of maximum intensity of wheeze bands) were analyzed using lung-sound analysis. Patients were divided into 3 groups based on sleep disturbance on the first night after wheezing was recorded: mild group (no sleep disturbance and disappearance of wheezing within 2 days), moderate group (no sleep disturbance but disappearance of wheezing after 3 or more days), and severe group (sleep disturbance and disappearance of wheezing after 3 or more days). Wheezing characteristics on the first morning were compared among the 3 groups based on sleep disturbance on the first night.

The highest frequency, the frequency of maximum intensity, and the number of wheeze bands per 30 seconds were significantly higher in the severe group than in the mild group (p < 0.005, p < 0.005, p < 0.001, respectively). The number of wheeze bands per 30 seconds was a predictor of nighttime sleep disturbance, with a cutoff value of 11.1. The sensitivity, specificity, and positive- and negative-predictive values were 100%, 65%, 32%, and 100% (p < 0.001), respectively, with an area under the curve of 0.86 ± 0.05.

The number of wheeze bands per 30 seconds on lung-sound analysis was a useful indicator of risk of prolonged exacerbation.