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Cough and sleep in inner-city children
P Fuller1, A Picciotto, M Davies
1Queen Elizabeth Hospital for Children, London, UK.
Insights
Nighttime cough in children has a weak link to sleep disruption. Reducing coughs may slightly improve sleep, but parents struggle to accurately assess their child's sleep quality.
Area of Science:
- Pediatrics
- Sleep Medicine
- Respiratory Medicine
Background:
- Persistent nighttime cough is common in children.
- Understanding the impact of cough on pediatric sleep is crucial for effective management.
- Parental perception of cough and sleep disturbance requires investigation.
Purpose of the Study:
- To determine if nighttime cough disrupts children's sleep.
- To describe the relationship between cough frequency and sleep state in children.
- To assess parents' ability to perceive their child's cough and sleep disturbances.
Main Methods:
- Video-recording of 39 children with persistent nighttime cough for 6 nights.
- Objective quantification of coughs and coding of sleep states (awake, restless, quiet).
- Correlation and regression analyses to examine cough-sleep relationships; parental questionnaires on cough and sleep perception.
Main Results:
- A weak correlation was found between the number of coughs and the percentage of time spent awake or in restless sleep.
- A causal relationship suggests halving coughs could reduce awake time by 9% and awake/restless time by 1%.
- Parents accurately identified coughing but largely failed to assess sleep disturbance, despite 82% detecting changes.
Conclusions:
- Nighttime cough has a limited impact on the overall percentage of sleep disruption in children.
- While reducing cough may offer marginal sleep benefits, parental perception of sleep quality is unreliable.
- Further research is needed to understand the nuances of cough and sleep interactions in pediatric populations.
Abstract:
This study aimed to determine whether cough at night keeps children awake, to describe the relationship between children's cough and sleep and to report parents' perceptions of their children's cough and sleep. Thirty-nine children with reported persistent cough at night (>3 weeks) were recruited and studied for 6 nights by video-recording. Coughs were counted and sleep state was coded for awake, restless sleep and quiet sleep. The relationships between cough and sleep state between subjects and within subjects were examined by correlation and regression. After night 2 the parents were asked whether their child had coughed or had disturbed sleep and after night 6 they were asked whether there had been any change. There was a weak relationship between log percentage of the night awake and log number of coughs (r=0.13, SE 0.036), and log (percentage of the night awake plus restless sleep) and log number of coughs (r=0.016, SE 0.0071). If the relationship between cough and sleep state is causal, halving the number of coughs will reduce the percentage of the night awake by 9% (95% confidence interval (CI) 4-15%) and percentage awake and restless by 1% (95% CI 0-2%). All but one parent correctly identified coughing and 82% detected change. Most could not comment on their child's sleep. Improvement in cough would result in little reduction in either the percentage of the night awake or awake and restless in the average child in the population studied. Parents could detect whether their children were coughing but not whether their sleep was disturbed.