Exposure to visible mould or dampness at home and sleep problems in children: Results from the LISAplus study

Associations between abnormal sleep behavior and indoor environmental risk factors among children with a chronic cough in Wuxi, China: a cross-sectional study

BACKGROUND

Indoor environmental factors, such as pet ownership, presence of cockroaches, mattress quality, fuel usage (gas or electricity), use of biomass for cooking and heating, exposure to tobacco smoke or household molds can significantly affect the sleep quality of children with chronic cough. However, data regarding the effects of indoor environmental conditions on sleep in this population are limited. This study aimed to assess the prevalence of abnormal sleep behaviors and to establish associations between indoor environmental factors and sleep behaviors among children with chronic cough in Wuxi, China.

METHODS

A cross-sectional design was employed in this study, involving children aged 3-18 years. Data on sociodemographic factors, allergies, home environmental exposures, and sleep characteristics of the participants were collected using paper-based questionnaires. The association between indoor environmental factors and sleep behaviors in children with chronic cough was analyzed using logistic regression models.

RESULTS

The findings demonstrated that the prevalence of chronic cough among children in Wuxi was 15.50%. The chronic cough group exhibited a significantly higher incidence of eczema, wheezing, rhinitis, food allergy, and nasosinusitis than the non-chronic cough group. In addition, children with chronic cough also tended to have a family history of sleep disorders and adenoid hypertrophy (P < 0.01). After adjusting for confounding factors, a significant association was observed between bruxism (teeth grinding) and chronic cough (sometimes: odds ratio [OR] = 1.04; confidence interval [CI] = 1.01-1.08; always: OR = 1.11; CI = 1.04-1.19; P < 0.01). Among children with chronic cough, recent home decoration was associated with sleepwalking (OR = 1.04; CI = 1.00-1.07; P < 0.05), mold exposure was associated with bruxism (OR = 1.15; CI = 1.0-1.31; P < 0.05), and carpet use at home was associated with apnea (OR = 1.09; CI = 1.02-1.17; P < 0.05), twitching during sleep (OR = 1.13; CI = 1.00-1.27; P < 0.01) and morning headache (OR = 1.14; CI = 1.05-1.23; P < 0.01).

CONCLUSION

Children with chronic cough are more prone to some abnormal sleep behaviors than children without chronic cough. Household decoration within a year, household mold exposure, and carpet use were all significantly positively associated with abnormal sleep behaviors in children with chronic cough. Our study provides novel insights into the impact of the indoor environment on children's sleep and the occurrence of chronic cough, offering guidance for tailored health promotion programs for families.

Household and housing determinants of sleep duration during the COVID-19 pandemic: Results from the COHESION Study

BACKGROUND

Public health measures in response to the COVID-19 pandemic forced individuals to spend more time at home. We sought to investigate the relationship between housing characteristics and sleep duration in the context of COVID-19.

METHODS

Our exploratory study was part of the COvid-19: Health and Social Inequities across Neighborhoods (COHESION) Study Phase-1, a pan-Canadian population-based cohort involving nearly 1300 participants, launched in May 2020. Sociodemographic, household and housing characteristics (dwelling type, dissatisfaction, access to outdoor space, family composition, etc.), and self-reported sleep were prospectively collected through COHESION Study follow-ups. We explored the associations between housing and household characteristics and sleep duration using linear regressions, as well as testing for effect modification by income satisfaction and gender.

RESULTS

Our study sample involved 624 COHESION Study participants aged 50 ± 16years (mean±SD), mainly women (78%), White (86%), and university graduates (64%). The average sleep duration was 7.8 (1.4) hours. Sleep duration was shorter according to the number of children in the household, income dissatisfaction, and type of dwelling in multivariable models. Sleep was short in those without access to a private outdoor space, or only having a balcony/terrace. In stratified analyses, sleep duration was associated with housing conditions dissatisfaction only in those dissatisfied with their income.

CONCLUSION

Our exploratory study highlights the relationship between housing quality and access to outdoor space, family composition and sleep duration in the context of COVID-19. Our findings also highlight the importance of housing characteristics as sources of observed differences in sleep duration.

Seasonal Changes in Sleep Patterns in Two Saskatchewan First Nation Communities

Sleep is crucial for maintaining the recovery and restoration of the body and brain. Less sleep is associated with poor mental and physical performance. Seasonal changes in sleep patterns can be observed. This paper examines seasonal effects on sleep timing, duration, and problems in two Cree First Nation communities in Saskatchewan, Canada. Data were available from a community survey of 588 adults aged 18 years and older (range: 18–78 years) with 44.2% males and 55.8% females. Results are presented using descriptive statistics and a binary logistic-regression model to identify the association between seasonal changes in sleep patterns, and demographic, social, and environmental factors. The participants reported sleeping the least during the spring and summer months and sleeping the most during the fall and winter months. This was further confirmed by sleep hours and the lower proportion of recommended hours of sleep during the spring and summer, and a higher proportion of longer sleep duration during the fall and winter months. There was no significant variation in sleeping onset and wake-up times by season. Overall, there were no significant differences in the prevalence of sleep deprivation, insomnia, and excessive daytime sleepiness by season. When stratified by age group and sex, some differences existed in the prevalence of sleep problems by season. More than two-thirds (68.6%) of the participants reported that there was a change in sleep patterns across seasons, and about 26.0% reported a very or extremely marked change in sleep patterns across seasons. Changes in sleep patterns by season were related to money left at the end of the month and damage caused by dampness in the house.

Sleep deprivation in two Saskatchewan First Nation communities: a public health consideration

Objectives

Sleep deprivation is a common problem in Canada and is associated with many health problems. More than a quarter of Canadians get fewer than the recommended sleep hours (<7 h). This paper examines the prevalence and risk factors for sleep deprivation in two First Nation communities in Saskatchewan, Canada.

Methods

The baseline cross-sectional survey was completed between 2018 and 2019 in collaboration with the two Cree First Nation communities in Saskatchewan, Canada. There were five hundred and eighty-eight participants participated in the survey from two communities. A Multivariate logistic regression model was used for analysis.

Results

The prevalence of sleep deprivation (<7 h of sleep) was 25.4%. The multivariate logistics regression revealed that middle and older age groups, visible mold in the house, and being male with nighttime insomnia symptoms were significantly associated with a higher risk of sleep deprivation among study participants in the study.

Conclusions

In these two First Nation communities, a higher proportion of the participants reported having sleep deprivation. This was a unique study, which evolved from ongoing research collaboration with two First Nation communities in Saskatchewan, Canada. Findings will be helpful in the management of patients with sleep deprivation in these communities; as well as for co-creating policy with the communities and future research priorities.

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The prevalence sleep deprivation was about 25% in these two First Nation communities.

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Association between sleep deprivation and males with nighttime insomnia observed.

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Another important finding was association between visible mold and sleep deprivation.

Prevalence of Insomnia in Two Saskatchewan First Nation Communities

Insomnia is a common problem in Canada and has been associated with increased use of health care services and economic burden. This paper examines the prevalence and risk factors for insomnia in two Cree First Nation communities in Saskatchewan, Canada. Five hundred and eighty-eight adults participated in a baseline survey conducted as part of the First Nations Sleep Health Collaborative Project. The prevalence of insomnia was 19.2% among participants with an Insomnia Severity Index score of ≥15. Following the definition of nighttime insomnia symptoms, however, the prevalence of insomnia was much higher, at 32.6%. Multivariate logistic regression modeling revealed that age, physical health, depression diagnosis, chronic pain, prescription medication use for any health condition, and waking up during the night due to terrifying dreams, nightmares, or flashbacks related to traumatic events were risk factors for insomnia among participants from two Saskatchewan Cree First Nation communities.

The effect of the indoor environment on wheeze- and sleep-related symptoms in young Indian children

Background

Environmental exposures have a significant effect on respiratory and sleep symptoms in young children. Although the effect of air pollution on the respiratory symptoms in young children is well-established, less is known about the effect of household environmental characteristics and practices on wheeze and sleep concerns.

Aims

The aim of this pilot study is to explore the association between household environmental characteristics and practices with the symptoms of wheezing and sleep concerns in the past year in a convenience sample of young Indian children.

Materials and Methods

A detailed questionnaire about the child's home environment and respiratory and sleep symptoms was administered to the caregivers of 190 outpatients aged between 6 months and 5 years old at a teaching hospital.

Results

Indoor environmental characteristics and cleaning techniques were analyzed for the association with wheeze and sleep disorders. Half (50%) of the cohort had the symptoms of wheezing and 21% had occasional or frequent sleep concerns. Sleeping with a stuffed toy was significantly associated with both wheezing and sleep concerns (P = 0.05).

Conclusions

: Sleeping with a stuffed toy was a risk factor for wheeze and a risk factor for sleep disorders independent of wheeze.

Prevalence of sleep-disordered breathing and associated risk factors in primary school children in urban and rural environments

INTRODUCTION

Sleep-disordered breathing (SDB) in primary school children is a significant problem, yet its prevalence is not well known outside large urban settings. Information on the burden and risk factors of SDB in children could be used to improve resource allocation when providing care across a large country. The objectives of this study were to assess the prevalence of SDB among school-aged children comparing rural and urban settings, and to investigate associated risk factors.

METHODS

In this cross-sectional study, a random sample of primary school students in Turkey were selected from urban and rural areas and data were collected using the Pediatric Sleep Questionnaire, asthma, and allergic rhinitis questionnaires completed by the parents.

RESULTS

Questionnaires were collected from a total of 139 schools from 58 provinces. A total of 11,013 students were contacted, and 9045 (73%) completed the study. There was no difference in the prevalence of SDB between rural and urban settings (16% vs. 15%, p = 0.612). Multivariate logistic regression analysis revealed that current wheezing, current rhinoconjunctivitis, being overweight, parental snoring, and current mold at home were significant risk factors for SDB in both rural and urban children. Current tobacco smoke exposure (OR = 1.48, 95%CI = 1.19-1.85), near roadway air pollution exposure (OR = 1.40, 95%CI = 1.108-1.791), and mold at home in the first year of life (OR = 1.68, 95%CI = 1.26-2.23) were associated with SDB in urban children. History of maternal/paternal adenotonsillectomy was a significant predictor of SDB in the rural setting (OR = 1.63, 95%CI = 1.12-2.39).

CONCLUSION

The prevalence of SDB is high in children living in both settings but associated risk factors may vary. Children residing in rural areas should also be screened for sleep-disordered breathing during routine health visits.

Relationships between Exposure to Bioaerosols, Moldy Surface and Symptoms in French Mold-Damaged Homes

Air quality in homes is a major concern in Europe, where people spend most of their time indoors. According to the World Health Organization, numerous houses are subject to dampness that can lead to mold growth, with associated health and economic consequences. Our goal was to characterize the human exposure to bioaerosols in French mold-damaged houses but also to study the effects of these bioaerosols as suffered by the inhabitants of these houses. A global approach including both field study and laboratory experimentation was used to investigate 48 mold-damaged homes. Among a wide fungal diversity, 101 viable species, Aspergillus versicolor, Penicillium chrysogenum and P. crustosum were observed as recurrent species and could be used as microbial indicators of indoor air quality. Statistical analyses highlighted a relationship between the concentrations of these recurrent molds and the levels of surface contamination by molds in homes. Fever, cough, dyspnea, flu-like symptoms were observed with several fungal strains (A. versicolor, P. chrysogenum and P. crustosum) or in relation to moldy odor. Relationships between particles of 2 to 15 µm diameter and headaches and dizziness were also observed. In our study, we identified a cutaneous effect (itching) in relationship to the airborne concentration of A. versicolor.

What does sleep hygiene have to offer children's sleep problems?

Sleep hygiene practices have been described extensively in the literature. There is considerably less clarity about relationships between particular elements of sleep hygiene and particular sleep outcomes, and which intervention approaches using sleep hygiene principles are effective. In this review, we describe themes extracted from a systematic review of the sleep hygiene literature. We systematically searched Psycinfo, CINAHL, Cochrane, Ovid Medline, Embase, and Web of Science Search Engines up to August, 2017. We included all studies that associated sleep hygiene (behaviors adjacent to bedtime and during the night) with sleep duration and/or sleep onset latency and/or night waking or that used sleep-hygiene based interventions to improve sleep duration and/or sleep onset latency and/or night waking (n = 44). We organized our findings into themes by age group, sleep hygiene factors, and interventions. We provide evidence-based recommendations about areas of sleep hygiene that have significant empirical support and those that require urgent attention.

Incidence of Daytime Sleepiness and Associated Factors in Two First Nations Communities in Saskatchewan, Canada

Excessive daytime sleepiness (EDS) is the tendency to sleep at inappropriate times during the day. It can interfere with day-to-day activities and lead to several health issues. The objective of this study was to investigate the association between income, housing conditions, and incidence of EDS in adults living in two Cree First Nations communities. The data for this study involved 317 individuals aged 18 years and older who participated in baseline and follow-up evaluations (after four years) of the First Nations Lung Health Project, which was conducted in Saskatchewan in 2012–2013 and 2016. Both at baseline and follow-up survey after four years, an Epworth Sleepiness Scale (ESS) score >10 was considered to be abnormal. Logistic regression models were used to assess relationships between abnormal ESS and covariates at baseline. In 2016, 7.6% (24/317) of the participants reported an ESS >10 with the mean being 12.8 ± 2.0. For the same group, the mean ESS at baseline was 6.9 ± 2.2. The incidence of subjective EDS based on the ESS >10 was estimated at 7.6% over four years. This study showed an association between incidence of subjective EDS and less money left over at end of the month, having a house in need of repairs, having water or dampness in the past 12 months, and damage caused by dampness.

Frequency and Management of Sleep Disturbance in Adults with Atopic Dermatitis: A Systematic Review

Introduction

Intense nocturnal pruritus as well as the complex pathophysiology of atopic dermatitis (AD) can severely affect sleep and become a major factor in negatively impacting quality of life in adults. However, much of the literature on sleep disturbance in AD patients is on the pediatric population, and it is not well studied in adults. Furthermore, limited studies are available to guide effective management of sleep disturbance in AD in general. We review the literature to present the studies that have investigated the relationship between AD and its effect on sleep in adults and provide an approach for clinicians caring for this population.

Methods

A systematic literature search was conducted through the PubMed and EMBASE databases using the search terms “atopic dermatitis” OR “eczema” AND “sleep.” The articles generated by the search and their references were reviewed.

Results

A high prevalence of sleep disturbance is experienced by adults with AD. The likelihood of sleep disturbance is much higher in patients with AD compared to those without AD. Sleep disturbance appears to worsen with AD severity. Pruritus and scratching appear to be large contributors to sleep disturbance in adult patients with AD.

Conclusion

It is important that clinicians evaluate the severity of AD and ask general questions about itching, sleep, impact on daily activities, and persistence of disease during each patient visit and follow-up with the complaint of sleep disturbance. Management of sleep disturbance in AD should focus on adequate disease control of AD as well as possible medical interventions to help improve sleep. The pathophysiology of sleep disturbance in AD is extremely complex, and further research is needed to better understand the interplay of the immune system, circadian rhythm, and environmental factors implicated in both AD and sleep.

[European birth cohorts: Early life exposure to microorganisms and health impact]

In recent years, many birth cohorts have been initiated in Europe, to assess the early life microbiological exposure of children in the indoor environment and better understanding the different effects (adverse/protectors) on health. The results of 12 European cohorts, with different methodologies for exposure and allergic risk assessment are summarized in this review. Four meta-analyzes of cohort are presented too. Microbiological researches in indoor environment seem to turn to a metrology of microbiological exposure, but few studies provide real quantitative data. Thus, the establishment of dose-effect relationship is not possible and can only be done by having a global view of the situation, provided by an identical metrological approach in the different studies, in a large-scale, in the context of large birth cohorts with children followed with strict criteria to establish the clinical diagnosis.

Exposure and Health Effects of Fungi on Humans

Fungi are ubiquitous microorganisms that are present in outdoor and indoor environments. Previous research has found relationships between environmental fungal exposures and human health effects. We reviewed recent articles focused on fungal exposure and dampness as risk factors for respiratory disease development, symptoms, and hypersensitivity. In particular, we reviewed the evidence suggesting that early exposure to dampness or fungi is associated with the development of asthma and increased asthma morbidity. Although outdoor exposure to high concentrations of spores can cause health effects such as asthma attacks in association with thunderstorms, most people appear to be relatively unaffected unless they are sensitized to specific genera. Indoor exposure and dampness, however, appears to be associated with an increased risk of developing asthma in young children and asthma morbidity in individuals who have asthma. These are important issues because they provide a rationale for interventions that might be considered for homes and buildings in which there is increased fungal exposure. In addition to rhinitis and asthma, fungus exposure is associated with a number of other illnesses including allergic bronchopulmonary mycoses, allergic fungal sinusitis, and hypersensitivity pneumonitis. Additional research is necessary to establish causality and evaluate interventions for fungal- and dampness-related health effects.