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Souza MR, Rosa DS, Alvarenga TA, Morelhão PK, Tufik S, Andersen ML. Do nocturnal asthma attacks influence sleep parameters and inflammatory markers? A cross-sectional population-based study. Sleep Breath 2024; 28:619-627. [PMID: 37833518 DOI: 10.1007/s11325-023-02935-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
PURPOSE To evaluate the effects of nocturnal asthma on sleep parameters and inflammatory markers according to the severity of the condition in participants in the São Paulo Epidemiologic Sleep Study (EPISONO). METHODS Data from the 2007 and 2018 editions of the EPISONO study were utilized. Subjects completed validated sleep and respiratory questionnaires, underwent nocturnal polysomnography and spirometry tests, and provided blood samples for the assessment of inflammatory parameters. RESULTS Of 72 participants (67% women), 53% (n = 38) had intermittent nocturnal asthma symptoms and 47% (n = 34) had persistent asthma (mild, moderate, and severe). Individuals with persistent nocturnal symptoms had a higher body mass index (BMI), were more likely to have respiratory symptoms, and had worse lung function, a higher apnea-hypopnea index (AHI), and higher desaturation index than individuals with intermittent nocturnal symptoms. Positive associations were identified between nocturnal asthma and obstructive sleep apnea (OSA). A higher frequency of OSA was observed in participants with persistent asthma and participants with OSA were more likely to have persistent than intermittent asthma. However, there were no significant differences between the immunological parameters of those with intermittent or persistent asthma. CONCLUSIONS This study highlights the relevance of nocturnal symptoms as a valuable indicator of asthma severity. The findings also add to the existing body of evidence linking nocturnal asthma and OSA.
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Affiliation(s)
| | - Daniela Santoro Rosa
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Priscila K Morelhão
- Sleep Institute, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, SP, 04024-002, Brazil
| | - Sergio Tufik
- Sleep Institute, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, SP, 04024-002, Brazil
| | - Monica L Andersen
- Sleep Institute, São Paulo, Brazil.
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, SP, 04024-002, Brazil.
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2
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Sowho MO, Koehl R, Shade R, Judge E, Woo H, Wu TD, Brigham EP, Hansel NN, Tversky J, Sterni LM, McCormack MC. Obstructive sleep apnea screening in children with asthma. Pediatr Pulmonol 2023; 58:1683-1690. [PMID: 36852547 DOI: 10.1002/ppul.26375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/18/2023] [Accepted: 02/26/2023] [Indexed: 03/01/2023]
Abstract
RATIONALE Obstructive sleep apnea is highly prevalent in children with asthma, particularly in obese children. The sleep-related breathing disorder screening questionnaire has low screening accuracy for obstructive sleep apnea in children with asthma. Our goal was to identify the questions on the sleep-related breathing disorder survey associated with obstructive sleep apnea in children with asthma. METHODS Participants completed the survey, underwent polysomnography and their body mass index z-score was measured. Participants with survey scores above 0.33 were considered high risk for obstructive sleep apnea and those with an apnea-hypopnea index ≥ 2 events/h classified as having obstructive sleep apnea. Logistic regression was used to examine the association of each survey question and obstructive sleep apnea. Positive and negative predictive values were calculated to estimate screening accuracy. RESULTS The prevalence of obstructive sleep apnea was 40% in our sample (n = 136). Loud snoring, morning dry mouth, and being overweight were the survey questions associated with obstructive sleep apnea. The composite survey score obtained from all 22 questions had positive and negative predictive values of 51.0% and 65.5%, while the combined model of loud snoring, morning dry mouth, and being overweight had positive and negative predictive values of 60.3% and 77.6%. On the other hand, the body mass index z-score alone had positive and negative predictive values of 76.3% and 72.2%. CONCLUSIONS The body mass index z-score is useful for obstructive sleep apnea screening in children with asthma and should be applied routinely given its simplicity and concerns that obstructive sleep apnea may contribute to asthma morbidity.
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Affiliation(s)
- Mudiaga O Sowho
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rachelle Koehl
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rebecca Shade
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eliza Judge
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Han Woo
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tianshi David Wu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Emily P Brigham
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jody Tversky
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Laura M Sterni
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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3
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Xu C, Li L, Wang C, Jiang J, Li L, Zhu L, Jin S, Jin Z, Lee JJ, Li G, Yan G. Effects of G-Rh2 on mast cell-mediated anaphylaxis via AKT-Nrf2/NF-κB and MAPK-Nrf2/NF-κB pathways. J Ginseng Res 2021; 46:550-560. [PMID: 35818417 PMCID: PMC9270651 DOI: 10.1016/j.jgr.2021.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/04/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
Background The effect of ginsenoside Rh2 (G-Rh2) on mast cell-mediated anaphylaxis remains unclear. Herein, we investigated the effects of G-Rh2 on OVA-induced asthmatic mice and on mast cell-mediated anaphylaxis. Methods Asthma model was established for evaluating airway changes and ear allergy. RPMCs and RBL-2H3 were used for in vitro experiments. Calcium uptake, histamine release and degranulation were detected. ELISA and Western blot measured cytokine and protein levels, respectively. Results G-Rh2 inhibited OVA-induced airway remodeling, the production of TNF-α, IL-4, IL-8, IL-1β and the degranulation of mast cells of asthmatic mice. G-Rh2 inhibited the activation of Syk and Lyn in lung tissue of OVA-induced asthmatic mice. G-Rh2 inhibited serum IgE production in OVA induced asthmatic mice. Furthermore, G-Rh2 reduced the ear allergy in IgE-sensitized mice. G-Rh2 decreased the ear thickness. In vitro experiments G-Rh2 significantly reduced calcium uptake and inhibited histamine release and degranulation in RPMCs. In addition, G-Rh2 reduced the production of IL-1β, TNF-α, IL-8, and IL-4 in IgE-sensitized RBL-2H3 cells. Interestingly, G-Rh2 was involved in the FcεRI pathway activation of mast cells and the transduction of the Lyn/Syk signaling pathway. G-Rh2 inhibited PI3K activity in a dose-dependent manner. By blocking the antigen-induced phosphorylation of Lyn, Syk, LAT, PLCγ2, PI3K ERK1/2 and Raf-1 expression, G-Rh2 inhibited the NF-κB, AKT-Nrf2, and p38MAPK-Nrf2 pathways. However, G-Rh2 up-regulated Keap-1 expression. Meanwhile, G-Rh2 reduced the levels of p-AKT, p38MAPK and Nrf2 in RBL-2H3 sensitized IgE cells and inhibited NF-κB signaling pathway activation by activating the AKT-Nrf2 and p38MAPK-Nrf2 pathways. Conclusion G-Rh2 inhibits mast cell-induced allergic inflammation, which might be mediated by the AKT-Nrf2/NF-κB and p38MAPK-Nrf2/NF-κB signaling pathways.
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Affiliation(s)
- Chang Xu
- Jilin Key Laboratory for Immune and Targeting Research on Common Allergic Diseases, Yanbian University, Yanji, China
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
| | - Liangchang Li
- Jilin Key Laboratory for Immune and Targeting Research on Common Allergic Diseases, Yanbian University, Yanji, China
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
| | - Chongyang Wang
- Jilin Key Laboratory for Immune and Targeting Research on Common Allergic Diseases, Yanbian University, Yanji, China
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
| | - Jingzhi Jiang
- Jilin Key Laboratory for Immune and Targeting Research on Common Allergic Diseases, Yanbian University, Yanji, China
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
| | - Li Li
- Jilin Key Laboratory for Immune and Targeting Research on Common Allergic Diseases, Yanbian University, Yanji, China
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
| | - Lianhua Zhu
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
- Department of Dermatology, Yanbian University Hospital, Yanji, China
| | - Shan Jin
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
- Department of Dermatology, Yanbian University Hospital, Yanji, China
| | - Zhehu Jin
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
- Department of Dermatology, Yanbian University Hospital, Yanji, China
| | - Jung Joon Lee
- College of Pharmacy, Yanbian University, Yanji, China
| | - Guanhao Li
- Jilin Key Laboratory for Immune and Targeting Research on Common Allergic Diseases, Yanbian University, Yanji, China
- Food Research Center of Yanbian University, Yanji, China
- Corresponding author. Food Research Center of Yanbian University, No. 977 Gongyuan Road, Yanji, 133002, PR China.
| | - Guanghai Yan
- Jilin Key Laboratory for Immune and Targeting Research on Common Allergic Diseases, Yanbian University, Yanji, China
- Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, Yanji, China
- Corresponding author. Department of Anatomy, Histology and Embryology, Medical College, Yanbian University, No. 977 Gongyuan Road, Yanji, 133002, PR China.
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4
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Garcia-Marcos L, Sanchez-Solis M. Does asthma cause sleep disorders … or the other way around? J Pediatr (Rio J) 2021; 97:366-368. [PMID: 33545025 PMCID: PMC9432254 DOI: 10.1016/j.jped.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Luis Garcia-Marcos
- University of Murcia, Arrixaca University Children's Hospital, Respiratory and Allergy Units, Murcia, Spain; Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Carlos III Health Institute, Network of Asthma, and Adverse and Allergy Reactions (ARADyAL) Network, Madrid, Spain.
| | - Manuel Sanchez-Solis
- University of Murcia, Arrixaca University Children's Hospital, Respiratory and Allergy Units, Murcia, Spain; Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain; Carlos III Health Institute, Network of Asthma, and Adverse and Allergy Reactions (ARADyAL) Network, Madrid, Spain
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5
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Guo Y, Zhang X, Liu F, Li L, Zhao D, Qian J. Relationship between Poorly Controlled Asthma and Sleep-Related Breathing Disorders in Children with Asthma: A Two-Center Study. Can Respir J 2021; 2021:8850382. [PMID: 33574970 PMCID: PMC7861934 DOI: 10.1155/2021/8850382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/25/2020] [Accepted: 01/18/2021] [Indexed: 12/17/2022] Open
Abstract
Objective Asthma and sleep-related breathing disorders (SRBD) are common chronic respiratory diseases in children. The relationship between asthma and SRDB is bidirectional. However, only a few studies have analyzed the relationship between asthma control status and risk of SRBD. The aim of this study was to evaluate the relationship between asthma control and SRBD and further assess the relationship between therapy/atopy/lung function of children with asthma and SRBD. Methods A total of 209 children aged 3-16 years were enrolled in this study. Pediatric sleep questionnaire (PSQ) scores were used to identify children at high risk of developing SRBD. Data on asthma control status, therapy, allergy, lung function, and exhaled nitric oxide were collected. Results A significantly higher risk of SRBD was found among children with poorly controlled asthma (34.25% vs. 13.97%, P < 0.01) and allergic rhinitis (AR) (34.29% vs. 13.92%, P < 0.01) than among children with well-controlled asthma and AR. The prevalence of SRBD was also significantly higher in asthmatic children with obesity than that with just obesity (42.11% vs. 20.00%, P < 0.05). Multiple logistic regression analysis showed that poorly controlled asthma (OR, 2.746 (95% CI, 1.215-6.209); P < 0.05) and poorly controlled AR (OR, 3.284 (95% CI, 1.430-7.544); P < 0.01) increased the odds of having SRBD. Conclusion Poorly controlled asthma and AR increase the risk of SRBD. A routine check of the level of asthma control and appropriate use of medication for AR are important because of their influence on SRBD.
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Affiliation(s)
- Yun Guo
- Department of Respiratory Medicine, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, China
| | - Xiuqing Zhang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China
- Department of Respiratory Medicine, Tianjin Children's Hospital, Tianjin, China
| | - Feng Liu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ling Li
- Department of Respiratory Medicine, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, China
| | - Deyu Zhao
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Qian
- Department of Respiratory Medicine, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, China
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6
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Briley PM, Merlo S. Presence of Allergies and Their Impact on Sleep in Children Who Stutter. ACTA ACUST UNITED AC 2020. [DOI: 10.1044/2020_persp-20-00095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
Population-based research has identified insomnia or trouble sleeping, sleepiness during the day, and fatigue during the day as frequent coexisting conditions in children who stutter (CWS). Considering that allergies are well known to disturb sleep, the purpose of this study was to explore if there is an association between the presence of allergies and sleep issues among CWS, as well as if allergies are frequent in CWS.
Method
Data from the 2012 National Health Interview Survey were used. Children used in this sample were those whose caregivers answered definitively whether or not the child stuttered within the past 12 months. Additionally, caregivers identified the presence of allergies and/or asthma and the presence of insomnia or trouble sleeping in the sample child.
Results
The sample included 200 CWS and 9,951 children who do not stutter (CWNS). The odds of insomnia/trouble sleeping were greater in CWS who present with allergies and/or asthma, with the exception of food allergy, compared to CWS who do not present with with allergies and/or asthma. Additionally, the odds of insomnia/trouble sleeping were greater in CWS without any allergy, asthma, and coexisting disability (
OR
= 7.48,
p
< .001) as compared to CWNS without any allergy, asthma, and coexisting disability. The presence of either any allergy or an asthma attack was higher among CWS (46.4%) compared to CWNS (29.5%),
p
< .001. Specifically, CWS were found to be at greater odds of presenting with any kind of respiratory allergy (
OR
= 1.72,
p
= .034), food allergy (
OR
= 2.32,
p
= .002), and skin allergy (
OR
= 1.84,
p
= .009) than CWNS.
Conclusions
CWS were found to be at greater odds of allergies and asthma, conditions that also impair sleep. Interestingly, insomnia/trouble sleeping was prevalent among CWS, even when allergies, asthma, and coexisting disabilities were not present. The possible implications of these findings are discussed.
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Affiliation(s)
- Patrick M. Briley
- Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC
| | - Sandra Merlo
- Brazilian Fluency Institute, Sao Paulo, Sao Paulo, Brazil
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7
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DelRosso LM, Picchietti DL, Spruyt K, Bruni O, Garcia-Borreguero D, Kotagal S, Owens JA, Simakajornboon N, Ferri R. Restless sleep in children: A systematic review. Sleep Med Rev 2020; 56:101406. [PMID: 33341437 DOI: 10.1016/j.smrv.2020.101406] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 02/06/2023]
Abstract
This systematic review assessed the prevalence of restless sleep in children, documented the association of restless sleep with other conditions, and summarized the existing evidence regarding whether restless sleep should be considered a distinct sleep disorder. A comprehensive search of electronic databases was performed using the broad search term "restless sleep" in all fields. Of the 266 articles retrieved, 107 were retained for inclusion in this review. The majority (n = 93) were observational studies. The studies were grouped under several pathologic/condition categories: sleep-disordered breathing (n = 19); adenotonsillectomy (n = 7); respiratory disorders, otitis media, and smoke exposure (n = 12); sleep-related movement disorders and restless sleep disorder (n = 11); neurologic or psychiatric disorders (n = 7); Down syndrome/other neurodevelopmental disorders (n = 10); sleep-related bruxism and other sleep disorders (n = 7); and restless sleep in the general population/mixed clinical samples (n = 18). A high prevalence of restless sleep was found in children with many of these underlying conditions, likely related to associated inherent sleep disruption and frequent awakenings (e.g., apnea and periodic limb movements), pain, sleep instability, and caregiver perception. The majority of studies identified restless sleep as reported by the caregiver, only 34 studies attempted to define restless sleep further. Four studies provided supportive evidence for designating restless sleep as an independent sleep disorder, restless sleep disorder (RSD). This review highlights the fact that the prevalence, etiology and sequelae (including daytime impairments) of restless sleep in children are important topics deserving of further research and that clinical definitions based on empirical evidence need to be developed. The designation of "primary" versus "secondary" restless sleep may be a useful construct, especially with regard to developing clinical trials and treatment algorithms.
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Affiliation(s)
- Lourdes M DelRosso
- University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
| | - Daniel L Picchietti
- University of Illinois School of Medicine, Carle Illinois College of Medicine, and Carle Foundation Hospital, Urbana, IL, USA.
| | - Karen Spruyt
- Lyon Neuroscience Research Center, INSERMU1028-CNRS UMR 5292 - Waking Team, University Claude Bernard, School of Medicine, Lyon, France.
| | - Oliviero Bruni
- Department of Developmental Neurology and Psychiatry, Sapienza University, Rome, Italy.
| | | | - Suresh Kotagal
- Department of Neurology and the Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Judith A Owens
- Division of Neurology, Boston Children's Hospital, Harvard Medical School, Waltham, MA, USA.
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8
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Lunsford-Avery JR, Keller C, Kollins SH, Krystal AD, Jackson L, Engelhard MM. Feasibility and Acceptability of Wearable Sleep Electroencephalogram Device Use in Adolescents: Observational Study. JMIR Mhealth Uhealth 2020; 8:e20590. [PMID: 33001035 PMCID: PMC7563632 DOI: 10.2196/20590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Adolescence is an important life stage for the development of healthy behaviors, which have a long-lasting impact on health across the lifespan. Sleep undergoes significant changes during adolescence and is linked to physical and psychiatric health; however, sleep is rarely assessed in routine health care settings. Wearable sleep electroencephalogram (EEG) devices may represent user-friendly methods for assessing sleep among adolescents, but no studies to date have examined the feasibility and acceptability of sleep EEG wearables in this age group. Objective The goal of the research was to investigate the feasibility and acceptability of sleep EEG wearable devices among adolescents aged 11 to 17 years. Methods A total of 104 adolescents aged 11 to 17 years participated in 7 days of at-home sleep recording using a self-administered wearable sleep EEG device (Zmachine Insight+, General Sleep Corporation) as well as a wristworn actigraph. Feasibility was assessed as the number of full nights of successful recording completed by adolescents, and acceptability was measured by the wearable acceptability survey for sleep. Feasibility and acceptability were assessed separately for the sleep EEG device and wristworn actigraph. Results A total of 94.2% (98/104) of adolescents successfully recorded at least 1 night of data using the sleep EEG device (mean number of nights 5.42; SD 1.71; median 6, mode 7). A total of 81.6% (84/103) rated the comfort of the device as falling in the comfortable to mildly uncomfortable range while awake. A total of 40.8% (42/103) reported typical sleep while using the device, while 39.8% (41/103) indicated minimal to mild device-related sleep disturbances. A minority (32/104, 30.8%) indicated changes in their sleep position due to device use, and very few (11/103, 10.7%) expressed dissatisfaction with their experience with the device. A similar pattern was observed for the wristworn actigraph device. Conclusions Wearable sleep EEG appears to represent a feasible, acceptable method for sleep assessment among adolescents and may have utility for assessing and treating sleep disturbances at a population level. Future studies with adolescents should evaluate strategies for further improving usability of such devices, assess relationships between sleep EEG–derived metrics and health outcomes, and investigate methods for incorporating data from these devices into emerging digital interventions and applications. Trial Registration ClinicalTrials.gov NCT03843762; https://clinicaltrials.gov/ct2/show/NCT03843762
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Affiliation(s)
- Jessica R Lunsford-Avery
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Casey Keller
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Andrew D Krystal
- Departments of Psychiatry and Neurology, University of California San Francisco School of Medicine, San Francisco, CA, United States
| | - Leah Jackson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Matthew M Engelhard
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
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9
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Guo Y, Pan Z, Gao F, Wang Q, Pan S, Xu S, Hui Y, Li L, Qian J. Characteristics and risk factors of children with sleep-disordered breathing in Wuxi, China. BMC Pediatr 2020; 20:310. [PMID: 32590970 PMCID: PMC7318769 DOI: 10.1186/s12887-020-02207-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022] Open
Abstract
Background Sleep-disordered breathing (SDB) is a common syndrome in children, related to their immune responses, cardiovascular function, and neurocognitive function. This study aimed to determine the prevalence of SDB among children in Wuxi, China, and to evaluate the protective and risk factors of SDB in children. Methods A cross-sectional study was conducted on children attending different schools across Wuxi, China, aged 3–14 years old. Of a total of 5630 questionnaires distributed to the parents of the children, 3997 (71.0%) were deemed to be valid. The data on the general sociodemographic factors, children’s allergy and sleep characteristics, and the parents’ sleep characteristics were also collected. The Paediatric Sleep Questionnaire (PSQ) score was used to identify children at high risk of SDB. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression. Results The prevalence of SDB in this cohort was 13.4% (N = 534). SDB prevalence significantly differed in children with asthma (28.2% vs. 12.8%, P < 0.001), eczema (19.0% vs. 10.0%, P < 0.001), urticaria (16.4% vs. 12.9%, P < 0.01) and rhinitis (21.4% vs. 10.7%, P < 0.001). No significant differences were found in SDB prevalence with respect to pillow material or quilt material. On multivariate logistic regression analysis, asthma (OR 1.986 (95% CI 1.312–3.007), P < 0.01), eczema (OR 1.675 (95% CI 1.377–2.037), P < 0.001), rhinitis (OR 1.998 (95% CI 1.635–2.441), suffered from familial sleep sickness (OR 2.416 (95% CI 1.975–2.955), P < 0.001) and whose mothers slept for a shorter duration (6 h–8 h: OR 1.370 (95% CI 1.089–1.724), P < 0.01; <6 h: OR 3.385(95% CI 2.098–5.461), P < 0.001) increased the odds of having SDB. The incidence of SDB significantly decreased with children’s age (6–11 years old: 0R 0.768 (95% CI 0.597–0.989), P < 0.05; 12–14 years old: OR 0.691 (95% CI 0.530–0.901), P < 0.01). Conclusion The results of this study demonstrated that atopic diseases (asthma, eczema, and rhinitis) and family sleep habits were risk factors for SDB in children in Wuxi, China.
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Affiliation(s)
- Yun Guo
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
| | - Zhenzhen Pan
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
| | - Fei Gao
- Department of Intensive Care Unit, Wuxi People's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
| | - Qian Wang
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
| | - Shanshan Pan
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
| | - Shiyao Xu
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
| | - Yu Hui
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
| | - Ling Li
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China.
| | - Jun Qian
- Department of Pediatric Respiratory, Wuxi Children's Hospital, Wuxi Clinical Medical College Affiliated to Nanjing Medical University, No.299-1 at Qingyang Road, Liangxi District, 214023, Wuxi, Jiangsu Province, People's Republic of China
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Pladeck T, Happel A, Mand N, Galetke W. Asthma bronchiale und Schlaf. SOMNOLOGIE 2020. [DOI: 10.1007/s11818-020-00249-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meltzer LJ, Forrest CB, de la Motte A, Bevans KB. Clinical Validity of the PROMIS Pediatric Sleep Measures across Populations of Children with Chronic Illnesses and Neurodevelopment Disorders. J Pediatr Psychol 2020; 45:319-327. [PMID: 31764969 PMCID: PMC7081937 DOI: 10.1093/jpepsy/jsz088] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine the clinical validity of the Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Sleep Disturbance (SD) and Sleep-Related Impairment (SRI) short forms. METHODS Youth (8-17 years) from clinical populations with known SDs (sleep clinic n = 126, autism n = 276, asthma n = 82, asthma + eczema n = 68) and the general population (n = 902) completed the PROMIS Pediatric SD and SRI 8-item short forms, along with established measures of sleep (Children's Report of Sleep Patterns, Sleep Habits Survey), PROMIS Pediatric Fatigue, and parent-reported clinical indicators (does child have sleep problem, use melatonin, use prescription sleep medication). RESULTS Confirmatory factor analyses demonstrated factorial invariance for all clinical groups. Significant differences between the general population and clinical groups were found for SD and SRI (medium to large effect sizes). Convergent validity was demonstrated through separate hierarchical regression models that showed significant associations between parent-reported clinical indicators and SD and SRI, above and beyond clinical group, as well as moderate to strong correlations between the PROMIS sleep measures and both established measures of sleep and fatigue. CONCLUSIONS The PROMIS Pediatric SD and SRI short forms provide clinicians and researchers a brief, accurate, and valid way to measure patient-reported sleep outcomes in pediatric populations.
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Affiliation(s)
| | - Christopher B Forrest
- Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - Anna de la Motte
- Applied Clinical Research Center, Children’s Hospital of Philadelphia
| | - Katherine B Bevans
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University
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Vecchierini MF. [Medical treatment of obstructive sleep-disordered breathing in children and adolescents]. Orthod Fr 2019; 90:311-320. [PMID: 34643518 DOI: 10.1051/orthodfr/2019027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Obstructive sleep disordered breathing (OSDB), in children and adolescents, need to be treated quite soon to avoid complications. A paediatrician, a sleep specialist, an orthodontist, an ENT and a myofunctional therapist will examine together the children with OSDB and determine the best personalised surgical and medical treatments for each of them. Only medical treatments are reviewed in this article. An international consensus recommended adenotonsillectomy as the first line therapy in young with OSDB. Usually adenotonsillectomy is combined with several important adjunctive medical treatments. Overweight and obesity frequent in adolescents, worsen OSDB and increase persistent OSDB after adenotonsillectomy. Weight loss is obtained by dietary restriction, physical activity, psychological support and sleep hygiene rules. Anti-inflammatory drugs (corticosteroids and leukotriene receptor antagonists) have shown their efficacy in children with moderate OSDB. Orthodontic treatments, rapid maxillary expansion or oral appliance, are used in selected patients according to their maxillo-facial disturbances in adjunction to adenotonsillectomy. Nasal CPAP is rarely useful except in severe OSDB specially in persistent OSDB after adenotonsillectomy. Finally, active or passive, myofunctional therapy is, according to some authors, an indispensable adjunct treatment to avoid persistent OSDB after adenotonsillectomy. These personalized medical treatments of OSDB are either administered jointly with adenotonsillectomy or in a hierarchal order.
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Affiliation(s)
- Marie-Françoise Vecchierini
- Centre du sommeil et de la vigilance, Hôtel-Dieu, Université Paris-Descartes, 1 place du Parvis Jean-Paul II, 75181 Paris cedex 04, France
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