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Lumertz MS, Friedrich FO, Loch LB, Pinto LA. Sleep and quality of life characteristics in a pediatric population with chronic obstructive respiratory diseases. Sleep Breath 2024; 28:945-949. [PMID: 38062225 DOI: 10.1007/s11325-023-02960-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 05/31/2024]
Abstract
PURPOSE To describe sleep and quality of life of pediatric patients with chronic obstructive respiratory diseases and to ascertain whether or not sleep quality correlates with quality of life in this population. METHODS Participants aged 5 to 18 years with cystic fibrosis (CF), severe asthma, or postinfectious bronchiolitis obliterans (PIBO) receiving regular follow-up at a pediatric respiratory medicine center were recruited. Two questionnaires were used: the Brazilian version of the Sleep Disturbance Scale for Children (SDSC) and the Pediatric Quality of Life Inventory (Peds-QL). RESULTS A total of 46 individuals were included: 30 with CF, 9 with severe asthma, and 7 with PIBO. Almost two-thirds of the patients and their parents or guardians scored at least 39 points on the SDSC, suggesting poor sleep quality. Significantly higher overall median scores were observed in those with severe asthma. Patients and their parents or guardians scored a median of 77 and 80 points respectively on the Peds-QL, with parents of patients with CF scoring higher than any other group. There was a moderate inverse correlation between sleep disorders and quality of life (r = - 0.532 for patients and r = - 0.606 for parents; p < 0.001). CONCLUSION Children and adolescents with chronic obstructive respiratory diseases experience impairment in their sleep quality and quality of life. Sleep disorders and quality of life have a moderate negative correlation.
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Affiliation(s)
- Magali Santos Lumertz
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil.
| | - Frederico Orlando Friedrich
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil
| | - Letícia Bortolini Loch
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil
| | - Leonardo Araújo Pinto
- Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6681, prédio 12A, Porto Alegre, RS, 90619-900, Brazil
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2
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Xavier WDS, Abreu MP, Nunes MDR, Silva-Rodrigues FM, da Silva LF, de Araújo BBM, De Bortoli PS, Neris RR, Nascimento LC. The Sleep Patterns of Children and Adolescents with Chronic Conditions and Their Families: An Integrative Literature Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:207. [PMID: 38397320 PMCID: PMC10887388 DOI: 10.3390/children11020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Sleep is of vital necessity for health, and it has a restorative and protective function for children and adolescents with chronic conditions and their families. The purpose of this study was to identify the scientific production on sleep patterns in children and adolescents with chronic conditions and their families. This integrative review was conducted between March and June 2022 using the databases of MEDLINE, Web of Science, CINAHL and PsycINFO. The articles included were original papers published between January 2007 and mid-2022. Excluded were review studies that did not evaluate sleep and whose participants did not have chronic conditions or were not children, adolescents and/or their families. The searches returned 814 abstracts. After exclusions, 47 studies were selected to be read in full; of these, 29 were selected and were grouped empirically into four categories: major alterations in the sleep patterns of children and adolescents with chronic conditions; the relationship between sleep disorders and symptoms in children and adolescents with chronic conditions; the impaired sleep patterns of families of children and adolescents with chronic conditions; and sleep alterations and their relationship with other problems in families of children and adolescents with chronic conditions. All studies showed sleep pattern impairment in children and adolescents with chronic conditions as well as their families.
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Affiliation(s)
- Welker da Silva Xavier
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Madalena Paulos Abreu
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Michelle Darezzo Rodrigues Nunes
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Fernanda Machado Silva-Rodrigues
- Maternal-Infant and Psychiatric Nursing Department, School of Nursing, University of Sao Paulo, São Paulo 05403-000, SP, Brazil;
| | - Liliane Faria da Silva
- Maternal-Infant and Psychiatric Nursing Department, Aurora de Afonso Costa School of Nursing, Fluminense Federal University, Niteroi 22020-091, RJ, Brazil;
| | - Barbara Bertolossi Marta de Araújo
- Department of Maternal-Infant Nursing, Nursing Faculty, Rio de Janeiro State University, Rio de Janeiro 20551-030, RJ, Brazil; (W.d.S.X.); (M.P.A.); (B.B.M.d.A.)
| | - Paula Saud De Bortoli
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
| | - Rhyquelle Rhibna Neris
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
| | - Lucila Castanheira Nascimento
- Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (P.S.D.B.); (R.R.N.); (L.C.N.)
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3
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Forer E, Golan Tripto I, Bari R, Shaki D, Goldbart A, Horev A. Effect of Paediatric Atopic Dermatitis on Parental Sleep Quality. Acta Derm Venereol 2023; 103:adv00879. [PMID: 36861857 PMCID: PMC9993168 DOI: 10.2340/actadv.v103.4872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/24/2023] [Indexed: 03/03/2023] Open
Abstract
Data on the impact of paediatric atopic dermatitis on parental sleep are scarce. The aim of this study was to examine the effects of paediatric atopic dermatitis on the quality of parents' sleep. This cross-sectional study included parents of patients with atopic dermatitis and parents of healthy children who completed validated Pittsburgh Sleep Quality Index questionnaires. The study and control groups were compared, as were results for mild and moderate atopic dermatitis with severe atopic dermatitis, mothers and fathers, and different ethnic groups. A total of 200 parents were enrolled. Sleep latency was significantly longer in the study group compared with the control group. Sleep duration was shorter in the parents of the mild AD group compared with the moderate-severe and control groups. Parents in the control group reported more daytime dysfunction than parents in the AD group. Fathers of children with AD reported more sleep disturbance than mothers.
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Affiliation(s)
- Ester Forer
- Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel.
| | - Inbal Golan Tripto
- 1Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Romi Bari
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - David Shaki
- 1Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Aviv Goldbart
- 1Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Amir Horev
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Pediatric Dermatology Service, Soroka University Medical Center, Beer Sheva, Israel.
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Smith S, Tallon M, Smith J, Angelhoff C, Mörelius E. Parental sleep when their child is sick: A phased principle-based concept analysis. J Sleep Res 2022; 31:e13575. [PMID: 35468663 PMCID: PMC9786861 DOI: 10.1111/jsr.13575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
Sleep is a common challenge for parents with sick children and can impact parents' health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle-based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence-based definition and to identify knowledge gaps. A systematic literature search including databases CINAHL, Embase, MEDLINE, PsychARTICLES, PsychINFO, Pubmed, Scopus and Web of Science, identified 546 articles. The final dataset comprised 74 articles published between 2005 and 2021 and was assessed using a criteria tool for principle-based concept analysis. Data were managed using NVivo, and thematic analysis was undertaken. A precise definition is not present in the literature. Various tools have been used to measure parents' sleep, as well as exploration via interviews, open-ended questions, and sleep diaries. The terminology used varied. Parental sleep when their child is sick is interrelated with other concepts (e.g., stress). A recommended definition is offered. A conceptual understanding of parental sleep when their child is sick will help to guide translational research and to conduct studies critical to clinical practice and research. Future research includes developing a measurement tool for parental sleep when their child is sick to be used in study design and future interventions.
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Affiliation(s)
- Stephanie Smith
- School of Nursing and MidwiferyEdith Cowan UniversityPerthWAAustralia,Perth Children's HospitalNedlands, PerthWAAustralia
| | - Mary Tallon
- School of NursingCurtin UniversityPerthWAAustralia
| | - James Smith
- Centre for Precision HealthCollaborative Genomics and Translation GroupSchool of Medical and Health SciencesEdith Cowan UniversityPerthWAAustralia,Centre for Healthcare Resilience and Implementation ScienceAustralian Institute for Health InnovationMacquarie UniversitySydneyNSWAustralia
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Evalotte Mörelius
- School of Nursing and MidwiferyEdith Cowan UniversityPerthWAAustralia,Perth Children's HospitalNedlands, PerthWAAustralia
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5
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Bakırlıoğlu B, Çetinkaya B. Factors affecting sleep quality of mothers of children with chronic illnesses. J Pediatr Nurs 2022; 66:e160-e165. [PMID: 35465997 DOI: 10.1016/j.pedn.2022.04.008] [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: 01/19/2022] [Revised: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This present research, mothers of children with chronic illnesses were compared with mothers of children with no chronic illnesses with the aim of determining which factors affect their sleep quality. DESIGN AND METHODS The descriptive-type data obtained from this research were collected from 270 mothers of children with chronic illnesses and 197 mothers of healthy children between November 10 and December 10, 2021. All participants were asked to complete a survey. The data were assessed using IBM SPSS Statistics Version 25 and the chi-square test, Fisher's exact test, t-test, ANOVA (Analysis of Variance), and Logistic Regression Analysis. RESULTS The total mean The Pittsburgh Sleep Quality Index (PSQI) score for mothers of chronically ill children was found to be 9.79 ± 3.68 while it was 6.68 ± 3.62 for mothers of heathy children with a statically significant difference (t = 9.075, p = 0.00). The fact that mothers wake up for the care/treatment of their children due to the onset of an illness was found to be associated with poor sleep quality (OR = 0.388 p = 0.017; OR = 0.178, p = 0.000). CONCLUSIONS In the present study, it was determined that mothers of children with chronic illnesses suffer from sleep problems and that the sleep quality of those mothers varies depending on the illness types of their children. PRACTICE IMPLICATIONS Pediatric nurses are requested to assess the sleep quality of mothers with suitable measurement tools to determine what types of problems affect sleep quality negatively when dealing with children with chronic illnesses in both clinical and non-clinical practices.
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Affiliation(s)
- Burcu Bakırlıoğlu
- Pamukkale University Faculty of Health Sciences, Department of Pediatric Nursing, Denizli, Turkey.
| | - Bengü Çetinkaya
- Pamukkale University Faculty of Health Sciences, Department of Pediatric Nursing, Denizli, Turkey.
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6
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Augustin M, Misery L, von Kobyletzki L, Armario-Hita JC, Mealing S, Redding M. Unveiling the true costs and societal impacts of moderate-to-severe atopic dermatitis in Europe. J Eur Acad Dermatol Venereol 2022; 36 Suppl 7:3-16. [PMID: 35801296 DOI: 10.1111/jdv.18168] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/01/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
Abstract
Atopic dermatitis (AD) is a chronic, auto-immune condition that imposes a high burden on individuals, society, and the healthcare system. Approximately 4.4% of adults and up to 18.6% of children/adolescents have AD in Europe, with 20% of all cases accounting for moderate-to-severe forms. This form of the condition in adults results in annual societal costs across Europe of an estimated €30 billion; €15.2 billion related to missed workdays or reduced work productivity, €10.1 billion related to direct medical costs and €4.7 billion related to personal expenditure of patients/families. AD can also substantially impact physical, emotional, and social quality-of-life. Several studies have shown the debilitating itch-scratch cycle is the main cause of the multifaceted burden, as it causes substantial sleep deprivation and stigmatisation due to the physical appearance of the skin, and confidence issues. These factors lead to psychosocial issues and can cumulate over time and prohibit patients reaching their 'full life potential'. Despite this, many patients with the condition are undertreated, resulting in uncontrolled symptoms and a further strain placed on patients, society, and the economy. The authors of this White Paper comprise the European Atopic Dermatitis Working Group, which is a network of international specialists with expertise in dermatology and healthcare policy decisions. Their programme of action is focused on harnessing their expertise to build consensus, advance research, share knowledge, and ultimately seek to improve AD care outcomes through achieving long-term symptom control. This White Paper presents a systematic evaluation of the overall financial and humanistic burden of moderate-to-severe AD and the current challenges that exist with AD care. It introduces recommendations for how, collaboratively, key stakeholders and policy makers can support improvements in AD management to achieve better disease control, thus reducing the costs and associated burden placed on individuals, society, and the economy.
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Affiliation(s)
- M Augustin
- University Medical Center Hamburg, Hamburg, Germany
| | - L Misery
- University Hospital of Brest, Brest, France
| | | | | | - S Mealing
- York Health Economics Consortium (YHEC), York, UK
| | - M Redding
- Eczema Outreach Support, Linlithgow, UK
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7
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Shah R, Ali FM, Finlay AY, Salek MS. Family reported outcomes, an unmet need in the management of a patient's disease: appraisal of the literature. Health Qual Life Outcomes 2021; 19:194. [PMID: 34353345 PMCID: PMC8339395 DOI: 10.1186/s12955-021-01819-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A person's chronic health condition or disability can have a huge impact on the quality of life (QoL) of the whole family, but this important impact is often ignored. This literature review aims to understand the impact of patients' disease on family members across all medical specialities, and appraise existing generic and disease-specific family quality of life (QoL) measures. METHODS The databases Medline, EMBASE, CINHAL, ASSIA, PsycINFO and Scopus were searched for original articles in English measuring the impact of health conditions on patients' family members/partner using a valid instrument. RESULTS Of 114 articles screened, 86 met the inclusion criteria. They explored the impact of a relative's disease on 14,661 family members, mostly 'parents' or 'mothers', using 50 different instruments across 18 specialities including neurology, oncology and dermatology, in 33 countries including the USA, China and Australia. These studies revealed a huge impact of patients' illness on family members. An appraisal of family QoL instruments identified 48 instruments, 42 disease/speciality specific and six generic measures. Five of the six generics are aimed at carers of children, people with disability or restricted to chronic disease. The only generic instrument that measures the impact of any condition on family members across all specialities is the Family Reported Outcome Measure (FROM-16). Although most instruments demonstrated good reliability and validity, only 11 reported responsiveness and only one reported the minimal clinically important difference. CONCLUSIONS Family members' QoL is greatly impacted by a relative's condition. To support family members, there is a need for a generic tool that offers flexibility and brevity for use in clinical settings across all areas of medicine. FROM-16 could be the tool of choice, provided its robustness is demonstrated with further validation of its psychometric properties.
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Affiliation(s)
- R. Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F. M. Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - A. Y. Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M. S. Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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Bawany F, Northcott CA, Beck LA, Pigeon WR. Sleep Disturbances and Atopic Dermatitis: Relationships, Methods for Assessment, and Therapies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:1488-1500. [PMID: 33321263 DOI: 10.1016/j.jaip.2020.12.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/28/2022]
Abstract
Atopic dermatitis is one of the most common chronic inflammatory skin conditions and is associated with sleep disturbances in 47% to 80% of children and 33% to 90% of adults. Herein, we review the literature on sleep disturbances experienced by patients with atopic dermatitis, as well as the mechanisms that may underlie this. We present subjective and objective methods for measuring sleep quantity and quality and discuss strategies for management. Unfortunately, the literature on this topic remains sparse, with most studies evaluating sleep as a secondary outcome using subjective measures. The development of portable, at-home methods for more objective measures offers new opportunities to better evaluate sleep disturbances in atopic dermatitis research studies and in clinical practice.
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Affiliation(s)
- Fatima Bawany
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY
| | - Carrie A Northcott
- Early Clinical Development, Digital Medicine and Translational Imaging, Pfizer, Inc, Cambridge, Mass
| | - Lisa A Beck
- Department of Dermatology, Medicine and Pathology, University of Rochester Medical Center, Rochester, NY
| | - Wilfred R Pigeon
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY.
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Marcuccio G, DI Bari MM, Precenzano F, Operto FF, Bitetti I, Motta G, Testa D. Relationship between sleep quality and rhinitis in children: role of medical treatment with isotonic and hypertonic saline. Minerva Pediatr (Torino) 2019; 73:301-306. [PMID: 31352769 DOI: 10.23736/s2724-5276.19.05563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The nose represents the port of entry, the first part of the upper airway and accounts for 50% of its total resistance. Many authors identified rhinitis as relevant factor affecting quality of life, and sleep habits of sufferers and their caregiver's, particularly between 4-17 years old children. Both allergic rhinitis and non-allergic rhinitis may represent an important risk for obstructive sleep apnea syndrome in children. We evaluated the quality of sleep and the role of nasal irrigations with saline solutions in children with sign and symptoms of rhinitis. METHODS An observational retrospective study was conducted on 58 children aged 3-6 years old receiving diagnosis of rhinitis according to clinical and amnestic evaluation. All recruited children were screened before medical topic treatment with the Pediatric Sleep Questionnaire test in order to evaluate the sleep habits and after isotonic and hypertonic saline nasal irrigation for six months. One-Way ANOVA was used for statistical analysis of the results. RESULTS Forty-nine of 58 recruited children reached the follow-up control after six months of medical treatment. Mean score at Pediatric Sleep Questionnaire before and after medical treatments was respectively 0.39 and 0.28. One-Way ANOVA test showed a significant statistical difference (P<0.05). CONCLUSIONS Nasal topic decongestant may be used only for short-term treatments, and they do not seem to have long-term results. Topic corticosteroids may be used for long term treatment and their correlations with OSA seem to have different results. This study aims to attracting the attention of pediatricians on the importance of nasal topic saline solutions irrigations in children with rhinitis in improving HRQoL decreasing snoring and apneas and so daytime symptoms.
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Affiliation(s)
- Giuseppina Marcuccio
- Unit of Head and Neck Surgery, Division of Otorhinolaryngology, Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy -
| | - Matteo Matteo DI Bari
- Unit of Head and Neck Surgery, Division of Otorhinolaryngology, Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Francesco Precenzano
- Unit of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Francesca F Operto
- Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Aldo Moro University, Bari, Italy
| | - Ilaria Bitetti
- Unit of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Gaetano Motta
- Unit of Head and Neck Surgery, Division of Otorhinolaryngology, Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Domenico Testa
- Unit of Head and Neck Surgery, Division of Otorhinolaryngology, Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
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Angelhoff C, Askenteg H, Wikner U, Edéll-Gustafsson U. "To Cope with Everyday Life, I Need to Sleep" - A Phenomenographic Study Exploring Sleep Loss in Parents of Children with Atopic Dermatitis. J Pediatr Nurs 2018; 43:e59-e65. [PMID: 30037591 DOI: 10.1016/j.pedn.2018.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE The whole family is affected when a child has atopic dermatitis (AD), and parents experience sleep disruption related to the child's condition leading to physical and mental exhaustion, mood swings, loss of concentration and lower job performance. This study aimed to explore and describe perceptions of sleep in parents of children <2 years old with AD, consequences of parental sleep loss, and what strategies the parents used to manage sleep loss and to improve sleep. DESIGN AND METHODS This qualitative interview study had an inductive and descriptive design. Twelve parents (eleven mothers and one father) participated in the study. Data analysis was performed using a phenomenographic approach. RESULTS Three categories of description were found: Acceptance and normalization of parental sleep loss; Changed routines and behavior to compensate for sleep loss; and Support is needed to gain sleep and manage daily life. CONCLUSIONS Sleep loss due to the child's AD affected the parents' emotional state, mood, well-being, cognitive function, ability to concentrate and take initiative, and sensitivity to stress and sound negatively. The parents managed their sleep loss mainly by changing their behavior and creating new routines, by taking me-time and through support from partners. PRACTICE IMPLICATIONS Pediatric nurses should acknowledge sleep loss in parents of small children with AD in time to prevent negative consequences, which affect the well-being of the entire family. Advice on how to improve sleep should be given early to increase the parents' understanding, make them feel safer and strengthen them in their parenthood.
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Affiliation(s)
- Charlotte Angelhoff
- Department of Social and Welfare Studies, Division of Nursing Sciences, Linköping University, Norrköping, Sweden; Department of Pediatrics and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
| | - Hanna Askenteg
- Department of Pediatrics and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
| | - Ulrica Wikner
- Department of Pediatrics and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
| | - Ulla Edéll-Gustafsson
- Department of Medicine and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden.
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Abstract
Allergic rhinitis affects 20 to 30% of adults in both the United States and Europe and perhaps a somewhat higher percentage of children. In addition to nasal and ocular symptoms directly related to the allergic process, interference of these symptoms with sleep leads to daytime sleepiness and impaired quality of life. Patients miss work because of symptoms but an even greater problem is interference with work productivity, or presenteeism, which has been reported to be the biggest contributor to the total economic cost of allergic rhinitis. There has been increasing awareness that many patients with either seasonal or perennial symptoms but negative skin and in vitro tests for allergen sensitivity have local nasal allergy, diagnosable by the presence of allergen-specific IgE in their nasal secretions or a positive nasal allergen challenge or both. The pharmaceutical management of allergic rhinitis rests on symptomatic treatment with antihistamines that perhaps are more effectively administered intranasally than orally and intranasal corticosteroids. Allergen immunotherapy is very effective, even for local allergic rhinitis, and the shortcomings of subcutaneous immunotherapy of inconvenience and safety are reduced by the introduction of sublingual immunotherapy (SLIT). Use of the latter is currently somewhat limited by the lack of appropriate dosing information for SLIT liquids and the limited number of allergens for which SLIT tablets are available.
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Affiliation(s)
- Flavia C. L. Hoyte
- Department of Medicine, Division of Allergy/Immunology, National Jewish Health, Denver, CO, 80206, USA
| | - Harold S. Nelson
- Department of Medicine, Division of Allergy/Immunology, National Jewish Health, Denver, CO, 80206, USA
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Novakova SM, Staevska MT, Novakova PI, Yoncheva MD, Bratoycheva MS, Musurlieva NM, Tzekov VD, Nicolov DG. Quality of life improvement after a three-year course of sublingual immunotherapy in patients with house dust mite and grass pollen induced allergic rhinitis: results from real-life. Health Qual Life Outcomes 2017; 15:189. [PMID: 28962623 PMCID: PMC5622572 DOI: 10.1186/s12955-017-0764-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/24/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Along with its high prevalence, the burden of allergic rhinitis rests upon the serious impact on quality of life of patients. Allergic rhinitis is associated with impairments in daily activities, work and school performance, and practical problems. Patients suffer from sleep disorders and emotional problems. Тhe advantages of sublingual immunotherapy on quality of life have only recently begun to emerge. The objective of this prospective real-life study was to evaluate the effect of a three-year course of sublingual immunotherapy with house dust mite (HDM) and grass pollen extracts on quality of life in adults with allergic rhinitis. METHODS A total number of 191 adult patients [105 (54,979%) men; mean age 27.3 years (SD-6.14)] with moderate to severe allergic rhinitis and clinically relevant sensitization to house dust mites or grass pollen were prospectively evaluated in the course of management of their disease. Health-related quality of life was assessed by Rhinoconjunctivitis Quality of Life Questionnaire at baseline and after three-year course of sublingual immunotherapy. RESULTS The mean overall Qol score assessed at baseline and at the end of the third year of treatment decreased significantly in patients treated with HDM extract (from 2.95 to 0.76) as well as with Grass pollen extract (from 2.83 to 1.22) (р < 0.001). The improvements in treated with HDM extract were as followed: activities - 3.52 to 0.68; sleep- 2.48 to 0.31; general problems - 1.79 to 0.49; practical problems - 3.57 to 0.68; nasal symptoms - 3.91 to 0.74; eye symptoms - 2.92 to 0.39; emotions - 3.03 to 0.39. The improvements in grass pollen group were: activities - 3.68 to 1.69; sleep- 1.85 to 0.84; general problems - 1.74 to 0.97; practical problems - 3.52 to 1.37; nasal symptoms - 3.72 to 1.57; eye symptoms - 3.58 to 1.3; emotions - 2.48 to 1.19. CONCLUSION Our study conducted in real life provided evidence that a three-year course of SLIT with HDM extract as well as with grass pollen extract significantly increased QoL in patients with allergic rhinitis.
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Affiliation(s)
- Silviya Mihaylova Novakova
- Allergy Unit of Internal Consulting Department, University hospital St. George, “Peshtersko shosse” 66, Plovdiv, Bulgaria
| | | | | | - Manuela Dimitrova Yoncheva
- Internal Consulting Department, University hospital “St. George”, “Peshtersko shosse” 66, Plovdiv, Bulgaria
| | - Maria Stoykova Bratoycheva
- Faculty of Public Health, Department of Social Medicine and Public Health, Medical University-Plovdiv, “Vasil Aprilov”15A, Plovdiv, Bulgaria
| | - Nina Mihaylova Musurlieva
- Faculty of Public Health, Department of Social Medicine and Public Health, Medical University-Plovdiv, “Vasil Aprilov”15A, Plovdiv, Bulgaria
| | - Valeri Dimitrov Tzekov
- Medical Faculty, The Second Internal Department, Medical University-Plovdiv, “Vassil Aprilov”15A, Plovdiv, Bulgaria
| | - Dimitar Georgiev Nicolov
- Medical Faculty, The Second Internal Department, Medical University-Plovdiv, “Vassil Aprilov”15A, Plovdiv, Bulgaria
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Urrutia-Pereira M, Solé D, Chong Neto HJ, Acosta V, Cepeda AM, Álvarez-Castelló M, Almendarez CF, Lozano-Saenz J, Sisul-Alvariza JC, Rosario NA, Castillo AJ, Valentin-Rostan M, Badellino H, Castro-Almarales RL, González-León M, Sanchez-Silot C, Avalos MM, Fernandez C, Berroa F, De la Cruz MM, Sarni ROS. Sleep disorders in Latin-American children with asthma and/or allergic rhinitis and normal controls. Allergol Immunopathol (Madr) 2017; 45:145-151. [PMID: 27594405 DOI: 10.1016/j.aller.2016.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/10/2016] [Accepted: 05/27/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Asthma and/or allergic rhinitis have been associated with sleep disorders. The aim of this study was to evaluate sleep disorders in Latin-American children (4-10 years) from nine countries, with persistent asthma (A) and/or allergic rhinitis (AR) and in normal controls (C). METHODS Parents from 454 C children and 700 A and/or AR children followed up in allergy reference clinics completed the Children's Sleep Habits Questionnaire (CSHQ) which is a retrospective one-week questionnaire composed of 33 questions composed of seven subscales (bedtime resistance, sleep duration, sleep anxiety, night wakings, parasomnias, sleep-disordered breathing and daytime sleepiness). The total scale of CSHQ and the subscales were compared between groups C and A+AR, A (n=285) vs. AR (n=390), and between controlled A (CA, n=103) vs. partially controlled/uncontrolled A (UA, n=182). RESULTS The comparison between C and A+AR showed no significant differences in age (6.7 years vs. 7.0 years, respectively), mean Body Mass Index and total scale of CSHQ (53.3 vs. 63.2, respectively) and the subscales were significantly higher in the A+AR group. Comparison between groups A and AR, except for sleep anxiety, showed significantly higher values for CSHQ total scale (66.9 vs. 61.0, respectively) and subscales for group A. The UA group showed significantly higher values for total CSHQ scale and subscales in comparison to CA (71.1 vs. 59.4, respectively). CONCLUSIONS Latin-American children with asthma and/or allergic rhinitis showed sleep disorders identified by the CSHQ when compared to normal controls. Despite being treated, asthma causes sleep impairment, especially when uncontrolled.
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Affiliation(s)
| | - D Solé
- Division of Allergy and Clinical Immunology, Federal University of São Paulo, São Paulo, Brazil.
| | - H J Chong Neto
- Department of Pediatrics, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - V Acosta
- Dr Avelino L. Castelán Pediatric Hospital, Chaco, Argentina
| | - A M Cepeda
- Hospital Universitario Metropolitano, Barranquilla, Colombia
| | | | | | | | | | - N A Rosario
- Department of Pediatrics, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - A J Castillo
- Centro de Medicina Avanzada Dr. Abel González, Santo Domingo, Dominican Republic
| | | | - H Badellino
- Clínica Regional del Este, Córdoba, Argentina
| | | | - M González-León
- Centro de Pesquisa: Consultorios del médico de familia, Havana, Cuba
| | | | - M M Avalos
- Allergy Service of the Hospital ISSSTE, Veracruz, Mexico
| | - C Fernandez
- Universidad Nacional Del Este, Asuncion, Paraguay
| | - F Berroa
- Centro de Medicina Avanzada Dr. Abel González, Santo Domingo, Dominican Republic
| | - M M De la Cruz
- Centro de Medicina Avanzada Dr. Abel González, Santo Domingo, Dominican Republic
| | - R O S Sarni
- ABC Foundation School of Medicine, Santo André, Brazil
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14
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Severity and disease control before house dust mite immunotherapy initiation: ANTARES a French observational survey. Allergy Asthma Clin Immunol 2016; 12:13. [PMID: 27069487 PMCID: PMC4827229 DOI: 10.1186/s13223-016-0119-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 02/08/2016] [Indexed: 01/13/2023] Open
Abstract
Background Allergen immunotherapy (AIT) may be prescribed for patients with allergic rhinitis (AR) induced by house dust mites (HDM) whether asthma is present or not. Current guidelines provide insufficient support for therapeutic management strategy of these patients. Allergists however have long-term experience with AIT. This study aims to describe the characteristics of the patients seen in clinical practice with HDM allergy and the process used to determine whether AIT should be initiated. Methods This was an observational, multicenter, prospective and cross-sectional study, conducted in France from 2013 to 2014 with a representative sample of allergy specialists. Any patient over 5 years of age with confirmed HDM allergy untreated with AIT within the last 12 months was eligible. Data were prospectively collected using physician and patient questionnaires. Results A total of 1589 patients (60 % adults, 40 % children) were included by 195 randomly selected allergists. A subgroup of 1212 patients (median age: 22 years; 52 % women) were selected for AIT treatment with a median time of AR diagnosis of 3 years. Amongst these, 59 % had a moderate to severe persistent AR according to AR and its Impact on Asthma guidelines, 57.5 % were polysensitized, and 56.5 % also suffered from conjunctivitis (median rhinitis total symptom score: 11). Asthma was present in 42 % of patients, and was controlled according to Global Initiative for Asthma guidelines in 62 % of patients. The asthma control questionnaire score was 1–1.5 in 20 % and ≥1.5 in 37 % of patients. A total of 57 % patients received a prescription of ≥2 medications (mainly antihistamines). Usual daily activities and sleep quality were slightly-to-moderately impaired as the mean rhinoconjunctivitis quality of life questionnaire score was 2.7 ± 1.5. The major driver of AIT prescription is AR uncontrolled by previous medications leading to patient dissatisfaction. Conclusions HDM-AR associated conjunctivitis was present in 60 % and asthma in 40 % of cases. In >40 % of these cases, asthma was inadequately controlled at the start of AIT.
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