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Concordance Between Asthma Symptom Reports and Objective Lung Function, and Associations With Sleep Outcomes in Urban
Daniella Teape1,2, Joshua R Tanzer3, Sheryl J Kopel1,2,4
1Department of Pediatrics, Hasbro Children's Hospital, Providence, Rhode Island, USA.
Insights
Asthma symptom concordance with lung function in children is linked to longer sleep duration. This relationship is influenced by the child's level of asthma control, suggesting tailored management strategies.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Asthma Research
Background:
- Asthma symptom recognition is crucial for effective management.
- Understanding the link between asthma symptoms and sleep quality in children is vital.
Purpose of the Study:
- To assess the association between asthma symptom concordance (ASC) or discordance (ASD) and sleep outcomes in children with persistent asthma.
- To determine if asthma control and severity influence the relationship between ASC and sleep outcomes.
Main Methods:
- Retrospective analysis of the Project NAPS observational study.
- Development of ASC and ASD measures from daily symptom reports and lung function over 4 weeks.
- Evaluation of ASC/ASD association with sleep efficiency, duration, and awakenings, considering asthma control and severity.
Main Results:
- Children with concordant asthma symptoms and lung function had longer sleep duration (15 min) and more nighttime awakenings.
- Well-controlled asthma in children correlated with significantly longer sleep duration (18 min).
Conclusions:
- Asthma symptom concordance with lung function is associated with improved sleep duration in children.
- Asthma control moderates the impact of symptom concordance on sleep duration.
- Optimizing asthma management to enhance symptom concordance may improve sleep duration.
Objectives:
To examine the extent to which asthma symptom concordance (ASC) or discordance (ASD) is associated with sleep outcomes in children with persistent asthma. Also, to investigate whether the association between ASC and sleep outcomes varies as a function of children's level of asthma control and severity.
Methods:
A retrospective data analysis of Project NAPS (Nocturnal Asthma and Performance in School), an observational study which examined asthma and sleep outcomes in children with persistent asthma. Measures of ASC and ASD were developed from daily self-reported asthma symptoms and lung function measurements performed over 4 weeks. The extent to which ASC and ASD were associated with sleep efficiency, duration, and awakenings was evaluated. Concordance and discordance of asthma symptoms with sleep outcomes were examined as a function of the child's asthma severity and control.
Results:
Those whose asthma symptom reports were in concordance with their lung function had longer sleep duration than children whose reports were discordant (difference = 15 min, Z = 2.61, p < 0.05), and more nighttime awakenings (difference = 0.6 awakenings, Z = 2.30, p < 0.05). Children with well-controlled asthma had longer sleep duration (difference = 18 min, p < 0.0001).
Conclusion:
This study builds on the literature on asthma symptom recognition by adding an evaluation of how ASC relates to sleep outcomes. Findings suggest that concordance of asthma symptoms with lung function is associated with longer sleep duration and moderated by asthma control. ASC may be important to sleep duration, which has important implications for tailoring asthma management to optimize symptom concordance.
Related Concept Videos
Asthma-III: Symptoms and Complications
Classification of Asthma
Lung Capacity
Asthma-I: Introduction
Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
Other Pulmonary Disorders

