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Petrov ME, Calvin S, Wyst KBV, Whisner CM, Meltzer LJ, Chen ACC, Felix KN, Roe-Sepowitz D. Sleep Disturbances and Hygiene of Adolescent Female Survivors of Domestic Minor Sex Trafficking. J Pediatr Health Care 2024; 38:52-60. [PMID: 37610406 DOI: 10.1016/j.pedhc.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION This cross-sectional quantitative study investigated the sleep hygiene and disturbances of adolescent female survivors of domestic minor sex trafficking (DMST) compared to an online sample of community-dwelling adolescent females. METHOD Community-dwelling adolescent females (aged 13-17 years, n = 61) and survivors of DMST housed in residental care (aged 12-17 years, n = 19) completed the Children's Report of Sleep Patterns (adolescent version). Descriptive statistics on sleep health in both samples were computed and compared using chi-square and t-tests. RESULTS Among the survivors of DMST, the majority reported insufficient sleep duration, okay-to-poor sleep quality, waking thirsty, and frequent nightmares. Compared with community-dwelling adolescents, survivors of DMST had more symptoms of insomnia, sleepiness, nightmares, and waking thirsty (p < .05). DISCUSSION Sleep disturbances among adolescent female survivors of DMST may be more prevalent than in community-dwelling adolescent females. Further empirical research on appropriate assessment and trauma-informed treatment of sleep in this population is needed.
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Koinis-Mitchell D, Boergers J, Yeo AJ, Molera G, Kopel SJ, McQuaid EL, Chen K, Wolfson AR, Chavez L, Jandasek B, Canino G. A Pilot Randomized Control Trial Demonstrating the Efficacy of the SIESTA Sleep Hygiene Intervention. Clin Pediatr (Phila) 2023:99228231207307. [PMID: 37905528 DOI: 10.1177/00099228231207307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Shorter sleep duration can negatively impact children's daytime functioning and health. Latino children living near urban areas in the Mainland U.S. and Island Puerto Rico (PR) can be exposed to urban poverty and sociocultural stressors that challenge optimal sleep outcomes. Interventions to improve urban Latino children's sleep health should consider families' cultural background and environmental context to enhance acceptability and feasibility. This work describes our stepwise, multimethod approach to adapting a culturally and contextually tailored "School Intervention to Enhance Latino Students' Time Asleep (SIESTA)" for sixth- to eighth-grade Latino children residing in Greater Providence and San Juan and findings from a pilot randomized control trial (RCT) demonstrating SIESTA's efficacy. Results indicated high acceptability and greater improvement of sleep duration and behaviors in SIESTA versus control participants. The SIESTA shows potential to improve sleep outcomes in urban Latino middle schoolers. Results will inform a large-scale RCT to evaluate SIESTA's effectiveness and barriers to implementation.
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Affiliation(s)
- Daphne Koinis-Mitchell
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Julie Boergers
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Anna J Yeo
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Grace Molera
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - Sheryl J Kopel
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Elizabeth L McQuaid
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Katie Chen
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - Amy R Wolfson
- Department of Psychology, Loyola University Maryland, Baltimore, MD, USA
| | - Ligia Chavez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Barbara Jandasek
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
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Chang Q, Zhu Y, Zhou G, Liang H, Li D, Cheng J, Pan P, Zhang Y. Vitamin D status, sleep patterns, genetic susceptibility, and the risk of incident adult-onset asthma: a large prospective cohort study. Front Nutr 2023; 10:1222499. [PMID: 37457981 PMCID: PMC10349527 DOI: 10.3389/fnut.2023.1222499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Vitamin D has been known to be associated with asthma, particularly in children, while the evidence among adults is limited and inconclusive. This study aimed to investigate the association between serum, vitamin D concentrations, and the incidence of adult-onset asthma and also the modified effect caused by sleep patterns and genetic risks. Methods A prospective cohort study with 307,872 participants aged between 37 and 73 years was conducted based on the UK Biobank, with a median follow-up of 12 years. The Cox proportional hazard model was applied to evaluate the association between vitamin D status and incident adult-onset asthma, and the modified effect was investigated by conducting stratified analysis according to sleep pattern score and genetic risk score, and subgroup analyses were performed by sex, age, BMI, and smoking status as well. Results Individuals with optimal vitamin D concentration were associated with 11.1% reduced risk of incident asthma compared to those participants with deficient vitamin D (HR = 0.889; 95% CI: 0.820-0.964; p = 0.005). Moreover, stratification analysis demonstrated that the protective effect of vitamin D on asthma risk was modified by sleep patterns or genetic susceptibility, with the strongest protective effect being observed in the subpopulation with a moderate sleep pattern (HR = 0.883; 95% CI: 0.797-0.977; p = 0.016) and a moderate genetic risk (HR = 0.817; 95% CI: 0.711-0.938; p = 0.004). In subgroup analyses, the protective effect of optimal vitamin D levels was only significant among men, individuals younger than 60 years of age, overweight individuals, and current or previous smokers. Conclusion Increased serum vitamin D levels were associated with a lower risk of incident adult-onset asthma, and this association was modified by sleep patterns and genetic predisposition to some extent.
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Affiliation(s)
- Qinyu Chang
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Yiqun Zhu
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Guowei Zhou
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huaying Liang
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Dianwu Li
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Jun Cheng
- Department of Spine Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Pinhua Pan
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Zhang
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Sim KY, Jang YS, Yoon NY, Park EC. Association between Asthma and Oral Health Symptoms in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2921. [PMID: 36833618 PMCID: PMC9958628 DOI: 10.3390/ijerph20042921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
Oral health is an indicator of patients' overall quality of life. Poor oral health among adolescents with asthma can affect their health in adulthood. This study researched the association between asthma and oral health symptoms in South Korean adolescents. Data from the 2020 Korea Youth Risk Behavior Web-based Survey were used. A total of 44,940 students participated in this study. The dependent variables were self-reported oral health symptoms. Asthma was the primary independent variable based on diagnosis in the past 12 months. The chi-squared test and multivariable logistic regression analysis were used. Students with asthma were associated with oral health symptoms, compared with those without asthma (boys, odds ratio (OR): 1.29, 95% confidence interval (CI) = 1.01-1.66; girls, OR: 1.94, 95% CI = 1.40-2.69). Poor health habits, such as low physical activity, higher sweetened beverage consumption, and fewer sleeping hours, were associated with oral health symptoms. Students who did not receive asthma treatment also had higher oral health symptoms (boys, OR: 1.29, 95% CI = 1.13-1.48, girls, OR: 1.34, 95% CI = 1.15-1.57). Students with absence due to asthma had a higher risk of oral health than those without asthma (boys, OR: 1.31, 95% CI = 1.17-1.46, girls OR: 1.28, 95% CI = 1.12-1.46). Students with asthma had a high risk of poor oral health among South Korean adolescents, suggesting more attention be given to regular dental check-ups and maintaining oral hygiene.
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Affiliation(s)
- Ka-Yun Sim
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
| | - Yun-Seo Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
| | - Na-Young Yoon
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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Bocek J, Prasko J, Genzor S, Hodny F, Vanek J, Pobeha P, Belohradova K, Ociskova M. Sleep Disturbance and Immunological Consequences of COVID-19. Patient Prefer Adherence 2023; 17:667-677. [PMID: 36941925 PMCID: PMC10024468 DOI: 10.2147/ppa.s398188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/18/2023] [Indexed: 03/14/2023] Open
Abstract
The overarching importance of sleep was further emphasized during the pandemic of COVID-19. The subjects infected by COVID-19 frequently experience sleep disturbances; some are long-lasting problems and decrease the quality of life. Insomnia is the most studied sleep disorder associated with COVID-19. Insomnia affects patients who have experienced an infection and the general population. Good sleep is important in maintaining mental and physical health, including immune system functions. The interconnections between insomnia, the immune system, and COVID-19 are complex. Insomnia triggers numerous immune system dysregulations and makes individuals more vulnerable to respiratory infections. This narrative review overviews the influence of the COVID-19 pandemic on the immune system through sleep disorders.
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Affiliation(s)
- Jonas Bocek
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
- Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic
- Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Beroun, The Czech Republic
- Correspondence: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital, I. P. Pavlova 6, Olomouc, 77520, The Czech Republic, Tel +420 603 414 930, Email
| | - Samuel Genzor
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Palacky Olomouc and University Hospital, Olomouc, The Czech Republic
| | - Frantisek Hodny
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Jakub Vanek
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Pavol Pobeha
- Department of Respiratory Diseases and Tuberculosis University Hospital and Faculty of Medicine and Dentistry Pavol Jozef Safarik University, Kosice, The Slovak Republic
| | - Kamila Belohradova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
- Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Beroun, The Czech Republic
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Asthma control, social jetlag, and sleep impairment in high school adolescents. Sleep Med 2022; 99:34-40. [DOI: 10.1016/j.sleep.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 11/23/2022]
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Okorie CUA, Afolabi-Brown O, Tapia IE. Pediatric pulmonary year in review 2021: Sleep medicine. Pediatr Pulmonol 2022; 57:2298-2305. [PMID: 35779240 DOI: 10.1002/ppul.26047] [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: 04/18/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 11/09/2022]
Abstract
Pediatric pulmonology publishes original research, review articles, and case reports on a wide variety of pediatric respiratory disorders. In this article, we summarized the past year's publications in sleep medicine and reviewed selected literature from other journals in this field. We focused on original research articles exploring aspects of sleep-disordered breathing in patients with underlying conditions such as cystic fibrosis, asthma, and sickle cell disease. We also explored sleep-disordered breathing risk factors, monitoring, diagnosis, and treatment; and included recent recommendations for drug-induced sleep endoscopy and ways to monitor and improve PAP adherence remotely.
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Affiliation(s)
- Caroline U A Okorie
- Division of Pediatric Pulmonology, Asthma and Sleep Medicine, Stanford Children's Health, Stanford, California, USA
| | - Olufunke Afolabi-Brown
- Sleep Center, Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ignacio E Tapia
- Sleep Center, Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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D'Angelo C, Jelalian E, Dunsiger S, Noga R, Kopel SJ, Boergers J, Mitchell K, Powers K, Koinis-Mitchell D. Physical Activity Among Urban Children with Asthma: Does Sleep Matter? J Clin Psychol Med Settings 2022; 29:666-677. [PMID: 34523033 DOI: 10.1007/s10880-021-09815-y] [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] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
The present study examined associations between sleep and physical activity among a diverse sample of 97 urban children (ages 7-9) with persistent asthma. Differences in associations were evaluated by race/ethnicity and weight status. The extent to which sleep moderated the association between lung function and physical activity was also evaluated. Generalized linear models were utilized to examine associations. Findings indicated that, among the aggregate sample, more frequent nighttime awakenings were associated with less time spent engaging in moderate-to-vigorous physical activity (MVPA). Important differences in these associations were identified by both race/ethnicity and weight status. Better lung function was associated with, (a) higher levels of MVPA for children with better sleep efficiency and fewer nighttime awakenings, and (b) lower levels of MVPA for children with poorer sleep efficiency and more frequent nighttime awakenings. In short, sleep mattered with respect to children's physical activity levels in this sample.
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Affiliation(s)
- Christina D'Angelo
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA.
- Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Elissa Jelalian
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rebecca Noga
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
| | - Sheryl J Kopel
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Julie Boergers
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Katherine Mitchell
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
| | - Kate Powers
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daphne Koinis-Mitchell
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
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Reiter J, Ramagopal M, Gileles-Hillel A, Forno E. Sleep disorders in children with asthma. Pediatr Pulmonol 2022; 57:1851-1859. [PMID: 33647191 PMCID: PMC8408281 DOI: 10.1002/ppul.25264] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 11/07/2022]
Abstract
Asthma and sleep disorders are both common in childhood, and often co-exist in the same child. Moreover, studies have shown that in many children the rate of one is influenced by the other. Sleep disorders can be classified into six different groups-insomnia, hypersomnia, parasomnia, movement disorders, circadian disorders, and sleep-related breathing disorders. Children with asthma often present with complaints of insomnia with poor sleep quality, difficulty falling asleep and sleep disruptions. These complains are often associated with asthma control. They may also complain of daytime sleepiness and have higher rates of parasomnias, such as night terrors and nocturnal enuresis when compared with their healthy peers. Whether movement and circadian disorders are also more prevalent in children with asthma is less clear. Finally, there is a complex bidirectional interaction between sleep-related breathing disorders and asthma: poor sleep and sleep disorders may worsen asthma, and asthma, particularly when it is poorly controlled, may impair sleep. In the current review we examine the association of each of the sleep disorders with asthma and review the common pathophysiological pathways. We hope to convince the reader that appropriate management of asthma must include inquiries into the patient's sleep, and vice versa.
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Affiliation(s)
- Joel Reiter
- Pediatric Pulmonary and Sleep Unit, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Maya Ramagopal
- Division of Pulmonary Medicine and Cystic Fibrosis Center, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New-Jersey, USA
| | - Alex Gileles-Hillel
- Pediatric Pulmonary and Sleep Unit, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, Children’s Hospital of Pittsburgh and University of Pittsburgh, PA
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Evans C, Fidler A, Baker D, Wagner M, Fedele D. Sleep and asthma management in youth with poorly-controlled asthma and their caregivers: a qualitative approach. J Asthma 2022; 59:1131-1138. [PMID: 33827372 PMCID: PMC10072859 DOI: 10.1080/02770903.2021.1914650] [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: 02/05/2023]
Abstract
OBJECTIVE Youth with poorly-controlled asthma are at increased risk for sleep disturbances caused by nocturnal symptoms like coughing. Asthma-related sleep disturbances can have downstream consequences for youth with asthma and their families. This study aims to describe (1) sleep disturbances in adolescents with poorly-controlled asthma and their caregivers and (2) the relationship between sleep and asthma management. METHODS Adolescents with poorly-controlled asthma and their caregivers completed the Family Asthma Management System Scale (FAMSS), a semi-structured interview that assesses youth asthma management within the family context. Interviews were audio-recorded and transcribed. Two authors coded each transcript for sleep-related data in NVivo using descriptive content analysis. RESULTS Thirty-three adolescents ages 12-15 years old (M = 13.2, SD = 1.2) with poorly-controlled asthma and their caregivers participated in this study. Four main themes emerged: sleep difficulties, sleep environment, sleep and self-management, and fatigue and self-management. 42% of youth and caregivers reported worse nocturnal asthma symptoms (e.g. coughing) that caused frequent nighttime awakening. Approximately 27% of caregivers expressed distress over their child's nocturnal asthma and described their management strategies (e.g. co-sleeping, nighttime symptom monitoring). Adolescents described sleepiness as a barrier to asthma self-management tasks (e.g. medication adherence, response to exacerbation). CONCLUSION Interview responses demonstrated the considerable interrelationship of sleep and asthma management in adolescents with poorly-controlled asthma. Asthma providers should consider discussing sleep difficulties with their adolescent patients and their families. Addressing these difficulties may help adolescents improve their asthma self-management and help caregivers better cope with their child's disease.
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Affiliation(s)
- Corinne Evans
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea Fidler
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Dawn Baker
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - Mary Wagner
- UF Health Pediatric Pulmonary, University of Florida, Gainesville, FL, USA
| | - David Fedele
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Baek EJ, Jung HU, Ha TW, Kim DJ, Lim JE, Kim HK, Kang JO, Oh B. Genome-Wide Interaction Study of Late-Onset Asthma With Seven Environmental Factors Using a Structured Linear Mixed Model in Europeans. Front Genet 2022; 13:765502. [PMID: 35432474 PMCID: PMC9005993 DOI: 10.3389/fgene.2022.765502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/28/2022] [Indexed: 11/30/2022] Open
Abstract
Asthma is among the most common chronic diseases worldwide, creating a substantial healthcare burden. In late-onset asthma, there are wide global differences in asthma prevalence and low genetic heritability. It has been suggested as evidence for genetic susceptibility to asthma triggered by exposure to multiple environmental factors. Very few genome-wide interaction studies have identified gene-environment (G×E) interaction loci for asthma in adults. We evaluated genetic loci for late-onset asthma showing G×E interactions with multiple environmental factors, including alcohol intake, body mass index, insomnia, physical activity, mental status, sedentary behavior, and socioeconomic status. In gene-by-single environment interactions, we found no genome-wide significant single-nucleotide polymorphisms. However, in the gene-by-multi-environment interaction study, we identified three novel and genome-wide significant single-nucleotide polymorphisms: rs117996675, rs345749, and rs17704680. Bayes factor analysis suggested that for rs117996675 and rs17704680, body mass index is the most relevant environmental factor; for rs345749, insomnia and alcohol intake frequency are the most relevant factors in the G×E interactions of late-onset asthma. Functional annotations implicate the role of these three novel loci in regulating the immune system. In addition, the annotation for rs117996675 supports the body mass index as the most relevant environmental factor, as evidenced by the Bayes factor value. Our findings help to understand the role of the immune system in asthma and the role of environmental factors in late-onset asthma through G×E interactions. Ultimately, the enhanced understanding of asthma would contribute to better precision treatment depending on personal genetic and environmental information.
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Affiliation(s)
- Eun Ju Baek
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Korea
| | - Hae Un Jung
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Korea
| | - Tae-Woong Ha
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Korea
| | - Dong Jun Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Korea
| | - Ji Eun Lim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Han Kyul Kim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ji-One Kang
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Bermseok Oh
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Korea.,Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
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12
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Heterogeneous Condition of Asthmatic Children Patients: A Narrative Review. CHILDREN 2022; 9:children9030332. [PMID: 35327702 PMCID: PMC8947522 DOI: 10.3390/children9030332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 11/17/2022]
Abstract
Currently, asthma represents the most common chronic disorder in children, showing an increasingly consistent burden worldwide. Childhood asthma, similar to what happens in adults, is a diversified disease with a great variability of phenotypes, according to genetic predisposition of patients, age, severity of symptoms, grading of risk, and comorbidities, and cannot be considered a singular well-defined disorder, but rather a uniquely assorted disorder with variable presentations throughout childhood. Despite several developments occurring in recent years in pediatric asthma, above all, in the management of the disease, some essential areas, such as the improvement of pediatric asthma outcomes, remain a hot topic. Most treatments of the type 2 (T2) target phenotype of asthma, in which IL-4, IL-5, and IL-13 modulate the central signals of inflammatory reactions. Although, there may be an unresolved need to identify new biomarkers used as predictors to improve patient stratification using disease systems and to aid in the selection of treatments. Moreover, we are globally facing many dramatic challenges, including climate change and the SARS-CoV2 pandemic, which have a considerable impact on children and adolescent asthma. Preventive strategies, including allergen immunotherapy and microbiome evaluation, and targeted therapeutic strategies are strongly needed in this population. Finally, the impact of asthma on sleep disorders has been reviewed.
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The modifiable biopsychosocial drivers of psychological distress for adolescents with asthma: Implications for Clinical Care. Paediatr Respir Rev 2022; 41:68-72. [PMID: 34531130 DOI: 10.1016/j.prrv.2021.07.005] [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: 04/18/2021] [Revised: 07/16/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Overwhelming distress exceeds the capacity of healthy coping strategies to feel better using healthy coping strategies alone, resulting in the use of unhealthy coping strategies. Unhealthy coping strategies may exacerbate asthma symptoms and asthma can contribute to overwhelming distress. This study aimed to review the modifiable drivers of overwhelming distress in adolescents with asthma. METHODS The biopsychosocial drivers of psychological distress for adolescents with asthma were explored within the domains of the modifiable biopsychosocial model of health and wellbeing. RESULTS Asthma in adolescents is associated with problems in the domains of environment, developmental outcomes, sense of belonging, health behaviours, coping, and treatment of illness. CONCLUSIONS The relationship between asthma and psychological distress highlights the need for holistic treatment of asthma. Further research is needed to establish causation between variables and to investigate whether interventions that address either asthma symptoms or biopsychosocial drivers of distress can improve both factors.
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Association of Symptoms of Sleep-Related Breathing Disorders with Asthma Control in Indian Children. Indian J Pediatr 2022; 89:31-36. [PMID: 34117623 DOI: 10.1007/s12098-021-03797-3] [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: 12/16/2020] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore the association of symptoms of sleep-related breathing disorders (SRBD) with asthma control in Indian children. METHODS This study was carried out in the pediatric chest clinic of a tertiary care center in western India. Children from 6 to 18 y of age with a physician-diagnosed case of asthma were included in the study. A validated pediatric sleep questionnaire, SRBD scale, was used to screen the symptoms of SRBD. At the same time, Asthma Control Questionnaire (ACQ) was administered to assess asthma control. RESULTS A total of 207 (73% boys) children with asthma were enrolled; the median age was 10 (7, 13) y. Asthma symptoms were well controlled (ACQ ≤ 0.75) in 102 (49.3%) and partly or poorly controlled (ACQ > 0.75) in 105 (50.7%) children. Inattention and/or hyperactivity was the most common SRBD symptom observed in 125 (60.4%) children; daytime sleepiness, mouth breathing, snoring, and night-time breathing problems were observed in 92 (44.5%), 91 (44%), 77 (37.2%), and 68 (32.8%) children, respectively. SRBD score showed a near-linear correlation with ACQ score (r = 0.28, p < 0.001). The score was positive in 52 (25.1%) children. A positive SRBD score was statistically more common in partly or poorly controlled asthma (aOR 2.5; 95% CI: 1.2-5.0; p = 0.01). However, the positive score did not show a statistically significant association with gender, being underweight, obesity, allergic rhinitis, compliance to therapy, and inhalation technique. CONCLUSION SRBD symptoms are common in children with asthma. They showed a statistically significant association with partly or poorly controlled asthma. Therefore, it would be interesting to look for SRBD symptoms in children with partly or poorly controlled asthma.
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Genzor S, Mizera J, Kiml J, Jakubec P, Sova M. Chronic lung diseases and sleep. VNITRNI LEKARSTVI 2022; 68:398-401. [PMID: 36316202 DOI: 10.36290/vnl.2022.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sleep is vitally important part of our life. Its quality and quantity influence all physiological processes in our organism. The relationship between the lung diseases and sleep is bidirectional - the lack of quality sleep worsens the compensation and the course of the diseases and in the same time chronic lung diseases are negatively affecting sleep quality. The coexistence of the sleep disordered breathing and lung disorders is another important issue to discuss. In case of chronic obstructive pulmonary disease the overlap with sleep disordered breathing is characterized by higher prevalence of hypercapnia and overall worse prognosis. Moreover, there is a growing body of evidence about possible links of sleep disordered breathing to lung fibrosis and tumors. The complex healthcare in patients with respiratory diseases should not omit sleep examination.
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16
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Estanislau NRDA, Jordão EADOC, Abreu GDA, Bloch KV, Kuschnir MCC, Felix MMR, Kuschnir FC. Association between asthma and sleep hours in Brazilian adolescents: ERICA. J Pediatr (Rio J) 2021; 97:396-401. [PMID: 32956628 PMCID: PMC9432073 DOI: 10.1016/j.jped.2020.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/10/2020] [Accepted: 07/24/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the association between asthma and sleep duration in participants of the Study of Cardiovascular Risks in Adolescents. MATERIALS AND METHODS Cross-sectional, national, school-based study, involving adolescents aged 12-17 years. In the period between 2013-14, data from 59,442 participants were analyzed. Bivariate analysis between current asthma and short sleep duration, defined as < 7 h/night, was performed separately with the other variables analyzed: sex, age group, type of school, weight categories, and common mental disorders. Then, different generalized linear models with Poisson family and logarithmic link functions were used to assess the independence of potential confounding covariates associated with both asthma and short sleep duration in the previous analysis. Crude and adjusted prevalence ratios and respective 95% confidence intervals were calculated, and a value of p < 0.05 was considered significant for all analyses performed. RESULTS Prevalence of current asthma was 13.4%, being significantly higher among students with short sleep duration (PR: 1.17; 95% CI: 1.01-1.35; p = 0.034). This remained significant even after adjusting for the other study covariates. CONCLUSION There was a positive association between the prevalence of current asthma and short sleep duration among Brazilian adolescents. Considering the high prevalence and morbidity of the disease in this age group, the promotion of sleep hygiene should be considered as a possible health strategy aimed at contributing to better control of asthma in this population.
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Affiliation(s)
| | | | | | - Katia Vergetti Bloch
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos de Saúde Coletiva, Rio de Janeiro, RJ, Brazil
| | | | - Mara M R Felix
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Fabio Chigres Kuschnir
- Universidade do Estado do Rio de Janeiro (UERJ), Programa de Pós-Graduação em Ciências Médicas, Rio de Janeiro, RJ, Brazil
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17
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Sonney JT, Thompson HJ, Landis CA, Pike KC, Chen ML, Garrison MM, Ward TM. Sleep intervention for children with asthma and their parents (SKIP Study): a novel web-based shared management pilot study. J Clin Sleep Med 2021; 16:925-936. [PMID: 32056537 DOI: 10.5664/jcsm.8374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
STUDY OBJECTIVES The objective of this study was to describe the feasibility, acceptability, and preliminary efficacy of a novel Sleep Intervention for Kids and Parents (SKIP). Parent and child primary sleep outcomes were total sleep time, wake after sleep onset (WASO), sleep efficiency (SE), and bedtime range. METHODS Children 6-11 years of age with asthma and 1 parent, both with behavioral sleep disturbance, enrolled in this single-group pilot. The 8-week shared management intervention included weekly online educational modules, goal setting, and progress reporting. Feasibility was measured by the number of dyads who were eligible, enrolled, and retained. Acceptability was measured by survey and semistructured interview. Total sleep time, WASO, SE, and bedtime range were measured by actigraphy at baseline, after the intervention, and 12-week follow-up. Mixed-effects regression models were used to determine change in sleep outcomes from baseline. RESULTS Thirty-three of 39 eligible dyads enrolled; of 29 dyads that started the intervention, 25 (86%) completed all study visits. SKIP was acceptable for 61% of children and 92% of parents. Compared with baseline, at follow-up, children had significantly improved WASO (-37 minutes; 95% confidence interval [CI], -44.5 to -29.7; P < .001), SE (5.4%; 95% CI, 4.2-6.5; P < .001), and bedtime range (-35.2 minutes; 95% CI, -42.9 to -27.5; P < .001). Parents also had significantly improved WASO (-13.9 minutes; 95% CI, -19.5 to -8.2; P < .001), SE (2.7%; 95% CI, 1.7-.7; P < .001), and bedtime range (-35.3 minutes; 95% CI, -51.0 to -19.7; P < .001). CONCLUSIONS SKIP was feasible, acceptable, and we observed improved child and parent sleep outcomes except total sleep time. Following refinements, further testing of SKIP in a controlled clinical trial is warranted. Clinical Trial Registration: Registry: ClinicalTrials.gov; Name: Sleep Intervention for Kids and Parents: A Self-Management Pilot Study; URL: https://www.clinicaltrials.gov/ct2/show/study/NCT03144531; Identifier: NCT03144531.
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Affiliation(s)
- Jennifer T Sonney
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington
| | - Hilaire J Thompson
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington
| | - Carol A Landis
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington
| | - Kenneth C Pike
- Office of Nursing Research, University of Washington School of Nursing, Seattle, Washington
| | - Maida L Chen
- Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Michelle M Garrison
- Department of Health Services, University of Washington School of Public Health, Division of Child and Adolescent Psychiatry, University of Washington School of Medicine, Seattle, Washington.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Teresa M Ward
- Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, Washington
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Fereidouni M, Rezapour H, Saharkhiz M, Mahmoudzadeh S, Ayadilord M, Askari M, Karbasi S, Abbaszadeh A, Hoseini ZS, Ferns GA, Bahrami A. A study of the association of cognitive abilities and emotional function with allergic disorders in young women. BMC WOMENS HEALTH 2021; 21:205. [PMID: 34001075 PMCID: PMC8130253 DOI: 10.1186/s12905-021-01345-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 05/06/2021] [Indexed: 01/31/2023]
Abstract
Background Allergic disorders may have a bidirectional causal relationship with mental disorders. In this cross-sectional study, we aimed to assess the associations between cognitive abilities and emotional function tests and quality of life with the presence of allergic disease in young women. Methods A diagnosis of allergic disorders, comprising allergic rhinitis (AR), asthma and atopic dermatitis (AD), was confirmed by a specialist in allergy. The presence and severity of depression, anxiety, stress, insomnia and sleepiness were evaluated using validated questionnaires. Cognitive abilities and quality of life were assessed using standard instruments. Results Among 181 female young participants, the prevalence of AR, asthma and AD were 26.5%, 2.8%, and 14.9% respectively. The AR group had higher scores than the non-AR group for depression, anxiety, insomnia, and lower scores for physical and mental health-related quality of life. Moreover, the AD cases had higher scores on the depression and stress scale compared to those without it (p < 0.05). Asthmatic patients also had significantly higher insomnia severity and lower physical health-related quality of life than non-asthmatic.
Conclusion There was a high prevalence of psychological/psychiatric disorders that included: anxiety, and sleep problems among allergic women, and a reduced quality of life that may be associated with it.
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Affiliation(s)
- Mohammad Fereidouni
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hadis Rezapour
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.,Department of Immunology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mansoore Saharkhiz
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.,Department of Immunology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Sara Mahmoudzadeh
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.,Department of Immunology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Malaksima Ayadilord
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.,Department of Immunology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoumeh Askari
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran.,Department of Anatomical Sciences, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Samira Karbasi
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran.,Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Arefeh Abbaszadeh
- Cardiovascular Diseases Research Center, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PH, Sussex, UK
| | - Afsane Bahrami
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran.
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García-Marín LM, Campos AI, Martin NG, Cuéllar-Partida G, Rentería ME. Inference of causal relationships between sleep-related traits and 1,527 phenotypes using genetic data. Sleep 2021; 44:5893494. [PMID: 32805044 DOI: 10.1093/sleep/zsaa154] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/30/2020] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVE Sleep is essential for both physical and mental health, and there is a growing interest in understanding how different factors shape individual variation in sleep duration, quality and patterns, or confer risk for sleep disorders. The present study aimed to identify novel inferred causal relationships between sleep-related traits and other phenotypes, using a genetics-driven hypothesis-free approach not requiring longitudinal data. METHODS We used summary-level statistics from genome-wide association studies and the latent causal variable (LCV) method to screen the phenome and infer causal relationships between seven sleep-related traits (insomnia, daytime dozing, easiness of getting up in the morning, snoring, sleep duration, napping, and morningness) and 1,527 other phenotypes. RESULTS We identify 84 inferred causal relationships. Among other findings, connective tissue disorders increase insomnia risk and reduce sleep duration; depression-related traits increase insomnia and daytime dozing; insomnia, napping, and snoring are affected by obesity and cardiometabolic traits and diseases; and working with asbestos, thinner, or glues may increase insomnia risk, possibly through an increased risk of respiratory disease or socio-economic related factors. CONCLUSION Overall, our results indicate that changes in sleep variables are predominantly the consequence, rather than the cause, of other underlying phenotypes and diseases. These insights could inform the design of future epidemiological and interventional studies in sleep medicine and research.
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Affiliation(s)
- Luis M García-Marín
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Adrián I Campos
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Nicholas G Martin
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gabriel Cuéllar-Partida
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Miguel E Rentería
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Global Brain Health Institute, University of California, San Francisco, CA, USA
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20
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Associations of sleep characteristics with atopic disease: a cross-sectional study among Chinese adolescents. Allergy Asthma Clin Immunol 2021; 17:21. [PMID: 33618771 PMCID: PMC7898413 DOI: 10.1186/s13223-021-00516-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/21/2021] [Indexed: 12/04/2022] Open
Abstract
Background Adolescence, as a transition between childhood and adulthood, is a critical stage for the long-term control of atopic diseases. We aim to determine if sleep characteristics are involved in the increased risk of atopic disease among adolescents. Methods Adopting the stratified cluster random sampling method, this cross-sectional survey included 4932 participants aged 12–18 years. The Chinese version of adolescent sleep disturbance questionnaire and the adolescent sleep hygiene scale were used to collect information on sleep problems and sleep hygiene, respectively. Logistic regression models were implemented to examine the associations of sleep with atopic diseases. Results Sleep duration was not found to be related with allergic diseases. By contrast, sleep-disordered breathing was associated with an increased risk of asthma (adjusted OR = 1.79, 95% CI 1.25–2.55), allergic rhinitis (adjusted OR = 1.95, 95% CI 1.52–2.49), and eczema (adjusted OR = 1.63, 95% CI 1.23–2.16); poor sleep physiology was correspondent to increased odds of asthma (adjusted OR = 1.69, 95% CI 1.24–2.29), allergic rhinitis (adjusted OR = 1.40, 95% CI 1.13–1.73) and eczema (adjusted OR = 1.66, 95% CI 1.32–2.09); non-optimal sleep environment was associated with an increased prevalence of asthma (adjusted OR = 1.52, 95% CI 1.08–2.12), allergic rhinitis (adjusted OR = 1.32, 95% CI 1.04–1.69) and eczema (adjusted OR = 1.53, 95% CI 1.19–1.96). Conclusions As sleep-disordered breathing, poor sleep physiology and non-optimal sleep environment were associated with a higher risk of allergic diseases, the results of this study provide a new concept for the adjuvant treatment of allergic diseases in adolescents. Management strategies of allergic diseases should take regular screening and targeted treatment of sleep issues into account.
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21
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Kaushal R, Bhardwaj P, Goel AD, Shekhar S, Kumar P, Goyal JP. Prevalence of Asthma and Sleep-Related Breathing Disorder in School-Going Children. Indian J Community Med 2020; 45:539-542. [PMID: 33623218 PMCID: PMC7877413 DOI: 10.4103/ijcm.ijcm_58_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 07/24/2020] [Indexed: 11/12/2022] Open
Abstract
Objective: The main objective of the study was to determine the prevalence of asthma and sleep-related breathing disorder (SRBD) in school-going children. Methods: This school-based, cross-sectional study was conducted among children of age groups of 6–7 and 13–14 years from 31 public and private schools in rural and urban areas of Jodhpur. A pretested and validated questionnaire in Hindi for childhood asthma, International Study of Asthma and Allergies in Childhood questionnaire and 22-item pediatric SRBD scale were used to collect data. Results: A total of 2245 children were screened for asthma and SRBD. The overall prevalence of asthma and SRBD in school children in Jodhpur was 8.0% (95% confidence interval [CI]: 6.9%–9.2%) and 9.5% (95% CI: 8.4–10.8), respectively. Asthma was found to be significantly associated with SRBD in school-going children in Jodhpur (odds ratio: 4.8; 95% CI: 3.3–6.8) on multiple logistic regression analysis. Conclusion: There is a significantly high prevalence of asthma and SRBD with a good association between them in school-going children.
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Affiliation(s)
- Rashmi Kaushal
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Shashank Shekhar
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prawin Kumar
- Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Hu Z, Tian Y, Zeng F, Song X. The Association Between Sleep Duration, Asthma-Related Episodes/Attacks and Emergency Department Visits. Nat Sci Sleep 2020; 12:253-262. [PMID: 32425626 PMCID: PMC7196773 DOI: 10.2147/nss.s243882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/01/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Inadequate sleep duration potentially increases the risk of allergic asthma; yet, the effect of different sleep duration on asthma-related episodes/attacks and emergency department (ED) visits has remained unclear. The purpose of this study is to evaluate the association between sleep duration, asthma-related episodes/attacks and ED visits. METHODS This study included 1526 asthma participants from the Behavioral Risk Factor Surveillance System Questionnaire during 2013-2017. Self-reported sleep duration was classified into three groups: ≤6 h (short), 7 h to 8 h (optimal) and ≥9 h (long). Generalized additive model with binomial or Poisson regression was used to complete all statistical analyses. RESULTS During a 12-month period, 857 participants reported acute episodes/attacks of asthma, and 279 participants reported asthma-related ED visits. Asthmatics with ED visits harbored significantly lower mean sleep duration (6.50 h vs 7.01 h, adjusted OR=0.93, 95% CI: 0.88-0.98) than those without episodes/attacks. After adjusting the potential confounding factors, the participants with long sleep duration were associated with lower risk of asthma-related episodes/attacks (adjusted OR=0.59, 95% CI: 0.41-0.86) than those with short sleep duration. The prevalence (adjusted OR=0.67, 95% CI: 0.47-0.94) and frequency (adjusted OR=0.83, 95% CI: 0.69-0.9996) of asthma-related ED visits among short sleepers were significantly higher than that among optimal sleepers. The differences of asthma-related episodes/attacks and ED visits between long and optimal sleepers were statistically insignificant. CONCLUSION Our study demonstrated that asthmatics with short sleep duration were associated with highest prevalence of asthma-related episodes/attacks and ED visits among the three sleep duration groups.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang 443003, People's Republic of China.,Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang,People's Republic of China.,Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yufeng Tian
- Department of Teaching Office, Three Gorges University, Yichang 443003, People's Republic of China
| | - Fanjun Zeng
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang 443003, People's Republic of China.,Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang,People's Republic of China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang 443003, People's Republic of China.,Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang,People's Republic of China
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Sundbom F, Malinovschi A, Lindberg E, Almqvist C, Janson C. Insomnia symptoms and asthma control-Interrelations and importance of comorbidities. Clin Exp Allergy 2019; 50:170-177. [PMID: 31631397 DOI: 10.1111/cea.13517] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/19/2019] [Accepted: 10/08/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Insomnia symptoms are common with asthma. The aim of the study was to analyse the associations between insomnia symptoms and asthma control, asthma severity, and asthma-related comorbidity in a community-based population. METHODS Adults (n = 23 875, ages 18-45) from the community-based LifeGene study answered a questionnaire on insomnia symptoms, airway symptoms, asthma diagnosis, asthma medication, and asthma-related comorbidities (chronic rhinosinusitis, gastro-oesophageal reflux, anxiety, depression, or obesity). RESULTS Of the participants, 1272 (5.3%) had asthma. The prevalence of any insomnia symptom was higher in participants with uncontrolled asthma (n = 201) than with controlled or partially controlled asthma (32.2% vs 19.9% and 20.1%, respectively, P < .01). There was no significant difference in the prevalence of insomnia symptoms between subjects with controlled asthma and subjects without asthma. Subjects with asthma and any asthma-related comorbidity reported more insomnia symptoms (29.0% vs 22.4%, P < .01) compared to asthmatics without comorbidity. Moreover, the prevalence was highest among subjects reporting both uncontrolled asthma and any asthma-related comorbidity (45.1%, P < .01). Uncontrolled asthma remained significantly associated with insomnia symptoms (OR 1.72 (1.15-2.56)) after adjusting for age, sex, BMI, smoking history, comorbidities, physical activity, and educational level, while medication level was not. Among asthma-related comorbidities, chronic rhinosinusitis (OR 1.62 (1.20-2.19)), obesity (1.87 (1.07-3.25)), and depression (OR 1.85 (1.34-2.55)) were independently associated with insomnia symptoms. CONCLUSION Uncontrolled asthma was significantly associated with insomnia symptoms, while controlled or partially controlled asthma was not. Asthma-related comorbidity is of great importance, and asthma control seems to be more important than asthma severity for insomnia symptoms.
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Affiliation(s)
- Fredrik Sundbom
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Sweden
| | - Eva Lindberg
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
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Burg GT, Covar R, Oland AA, Guilbert TW. The Tempest: Difficult to Control Asthma in Adolescence. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:738-748. [PMID: 29747981 DOI: 10.1016/j.jaip.2018.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 02/06/2023]
Abstract
Severe asthma is associated with significant morbidity and is a highly heterogeneous disorder. Severe asthma in adolescence has some unique elements compared with the features of severe asthma a medical provider would see in younger children or adults. A specific focus on psychological issues and adherence highlights some of the challenges in the management of asthma in adolescents. Treatment of adolescents with severe asthma now includes 3 approved biologic phenotype-directed therapies. Therapies available to adults may be beneficial to adolescents with severe asthma. Research into predictors of specific treatment response by phenotypes is ongoing. Optimal treatment strategies are not yet defined and warrant further investigation.
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Affiliation(s)
- Gregory T Burg
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
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Meltzer LJ, Beebe DW, Jump S, Flewelling K, Sundström D, White M, Zeitlin PL, Strand MJ. Impact of sleep opportunity on asthma outcomes in adolescents. Sleep Med 2019; 65:134-141. [PMID: 31751908 DOI: 10.1016/j.sleep.2019.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/11/2019] [Accepted: 07/13/2019] [Indexed: 12/28/2022]
Abstract
RATIONALE Insufficient sleep is associated with a number of negative health outcomes; as most adolescents obtain <7 h of sleep per night, it is important to understand how sleep impacts asthma among adolescents. OBJECTIVES To examine the impact of sleep opportunity on asthma in adolescents. METHODS In this study, 54 adolescents with asthma (12-17 years, 69% female, 65% Caucasian) participated in a randomized, cross-over sleep manipulation trial, including a sleep stabilization week, five nights of a "Short" sleep opportunity (time in bed: 6.5 h/night), and five nights of a "Long" sleep opportunity (time in bed: 9.5 h/night). Wake times were consistent across all three study weeks. Primary outcomes were lung function (daily peak expiratory flow rate, weekly spirometry) and functional asthma outcomes (daily asthma symptoms, Asthma Control Questionnaire, PROMIS Asthma Impact Scale). Markers of inflammation were also explored. MEASUREMENTS AND MAIN RESULTS Compared to the Long sleep week, during the Short sleep week, morning FEV1 was lower (p = 0.006), while asthma symptoms and albuterol use was higher (p < 0.05), and asthma showed a trend towards greater negative impact on daily life (p = 0.07). No differences were found for weekly measures of lung function or inflammation. CONCLUSIONS An insufficient sleep opportunity negatively impacts objective and subjective daily symptoms of asthma in adolescents, as well as health related quality of life. As most adolescents are significantly sleep deprived, it is important to target sleep health in the treatment of asthma.
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Affiliation(s)
| | - Dean W Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, USA
| | | | | | - D Sundström
- Department of Pediatrics, National Jewish Health, USA
| | - Michael White
- Department of Pediatrics, National Jewish Health, USA
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Khassawneh B, Tsai SC, Meltzer LJ. Polysomnographic characteristics of adolescents with asthma and low risk for sleep-disordered breathing. Sleep Breath 2019; 23:943-951. [PMID: 30689097 DOI: 10.1007/s11325-018-01774-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/21/2018] [Accepted: 12/18/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to describe the polysomnographic characteristics of adolescents with asthma who are at low risk for sleep-disordered breathing (SDB) based on the Pediatric Sleep Questionnaire (PSQ). METHODS Overnight polysomnography was performed on 85 adolescents with asthma and a score < 0.33 on the PSQ. The Asthma Control Questionnaire was used to define "well-controlled" versus "inadequately controlled" asthma. RESULTS Mean age of participants was 14.5 ± 1.6 years (range, 11 to 17 years), 63.5% were girls, 57.6% were Caucasians, and the mean body mass index percentile was 65.1 ± 26.5. Asthma was well-controlled in 51.7% of the adolescents and inadequately controlled in 15.3%. Mean sleep efficiency (SE) was 88.0 ± 11.1%, and 24.7% had SE < 85%. Mean wakefulness after sleep onset (WASO) was 40.9 ± 44.0 min, and the mean arousal index was 10.8 ± 5.6 per hour. The mean apnea/hypopnea index (AHI) was 2.3 ± 4.2, and 29.4% of participants had SDB (defined by an AHI ≥ 2). Compared with normative values, adolescents with asthma had more nocturnal awakenings and WASO, and less REM sleep. SDB risk was higher in boys [odds ratio = 4.6 (confidence interval 1.4-14.7), p = 0.01]. Asthma control did not impact sleep and respiratory parameters, with no differences found between youth with well-controlled and inadequately controlled asthma. CONCLUSIONS Adolescents with asthma are at increased risk of sleep-disordered breathing and suffer from disturbances in sleep continuity with more arousals and sleep fragmentation. Study results highlight the importance of proper screening for sleep-disordered breathing in adolescents with asthma.
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Affiliation(s)
- Basheer Khassawneh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. .,Department of Medicine, National Jewish Health, Denver, CO, USA.
| | - Sheila C Tsai
- Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, CO, USA
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Lawless C, Turner EM, LeFave E, Koinis-Mitchell D, Fedele DA. Sleep hygiene in adolescents with asthma. J Asthma 2018; 57:62-70. [PMID: 30543140 DOI: 10.1080/02770903.2018.1553049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Youth with asthma are at-risk for sleep difficulties due to nocturnal asthma symptoms. Sleep hygiene, or the ability to practice consistent sleep behaviors and habits, impacts youth sleep quality and may, as a result, influence daytime cognitive functioning. The current study sought to examine the impact sleep hygiene has on sleep quality, health-related quality of life (HRQL) and sustained attention among adolescents with asthma. It was hypothesized that worse sleep hygiene would be associated with poorer sleep quality, lower school-related and overall HRQL and worse sustained attention. Methods: Participants included 41 adolescents with persistent asthma (Mage = 14.83, SD = 1.28; 51.2% male) recruited from a pediatric pulmonology clinic. Participants completed the adolescent sleep hygiene scale (ASHS), Adolescent Sleep Wake Scale (ASWS) and the Pediatric Quality of Life Index 4.0 generic core scales (PedsQL). Participants also completed the psychomotor vigilance task (PVT), an objective test of sustained attention. Results: Higher sleep hygiene scores were related to higher reported sleep quality (β = 0.377, p = 0.015, f2 = 0.166), higher reported school-related HRQL (β = 0.321, p = 0.040, f2 = 0.115) and better sustained attention (β = 0.327, p = 0.045, f2 = 0.120). Conclusions: Sleep hygiene may be an important factor in sleep quality and deficits in daytime dysfunction including sustained attention and school-related quality of life. As adolescents with asthma are at heightened risk for these outcomes associated with disturbed sleep, sleep hygiene may serve as an important domain for clinical intervention.
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Affiliation(s)
- Casey Lawless
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Elise M Turner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Elizabeth LeFave
- Pediatric Pulmonary and Allergy Division, University of Florida, Gainesville, FL, USA
| | | | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Perla A V. The link between allergic disease and depression in young adults: A structural equation modelling analysis. ACTA ACUST UNITED AC 2018. [DOI: 10.17352/2455-5460.000033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Kallin SA, Lindberg E, Sommar JN, Bossios A, Ekerljung L, Malinovschi A, Middelveld R, Janson C. Excessive daytime sleepiness in asthma: What are the risk factors? J Asthma 2018; 55:844-850. [PMID: 27880055 DOI: 10.1080/02770903.2016.1263316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Previous studies have found that excessive daytime sleepiness (EDS) is a more common problem in asthmatic subjects than in the general population. The aim of this study was to investigate whether the prevalence of EDS is increased in asthmatic subjects and, if so, to analyse the occurrence of potential risk factors for EDS in asthmatics. METHODS Cross-sectional epidemiological study. In 2008, a postal questionnaire was sent out to a random sample of 45,000 individuals aged 16-75 years in four Swedish cities. RESULTS Of the 25,160 persons who participated, 7.3% were defined as having asthma. The prevalence of EDS was significantly higher in asthmatic subjects (42.1% vs. 28.5%, p < 0.001) compared with non-asthmatic subjects. Asthma was an independent risk factor for EDS (adjusted OR 1.29) and the risk of having EDS increased with asthma severity. Risk factors for EDS in subjects with asthma included insomnia (OR, 3.87; 95% CI, 3.10-4.84); chronic rhinosinusitis (OR, 2.00; 95% CI, 1.53-2.62); current smoking (OR, 1.60; 95% CI, 1.15-2.22) and obesity (OR, 1.53; 95% CI, 1.09-2.13). CONCLUSIONS EDS is a common problem among subjects with asthma. Asthma is an independent risk factor for having EDS. Furthermore, subjects with asthma often have other risk factors for EDS, many of them potentially modifiable.
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Affiliation(s)
- Sandra Andersson Kallin
- a Department of Medical Sciences : Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden
| | - Eva Lindberg
- a Department of Medical Sciences : Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden
| | - Johan Nilsson Sommar
- b Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Apostolos Bossios
- c Department of Internal Medicine and Clinical Nutrition , Krefting Research Centre, Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden
| | - Linda Ekerljung
- c Department of Internal Medicine and Clinical Nutrition , Krefting Research Centre, Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden
| | - Andrei Malinovschi
- d Department of Medical Sciences: Clinical Physiology , Uppsala University , Uppsala , Sweden
| | - Roelinde Middelveld
- e The Centre for Allergy Research, Karolinska Institutet , Stockholm , Sweden.,f The Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden
| | - Christer Janson
- a Department of Medical Sciences : Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden
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Lin YC, Lai CC, Chien CC, Chen CM, Chiang SR, Ho CH, Weng SF, Cheng KC. Is insomnia a risk factor for new-onset asthma? A population-based study in Taiwan. BMJ Open 2017; 7:e018714. [PMID: 29187415 PMCID: PMC5719310 DOI: 10.1136/bmjopen-2017-018714] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To determine whether insomnia at baseline is a risk factor for new-onset asthma. METHODS We recruited 48 871 patients with insomnia (insomnia group) newly diagnosed between 2002 and 2007, and 97 742 matched controls without insomnia (control group) from Taiwan's Longitudinal Health Insurance Database 2000. All of the patients were followed up for 4 years to see whether new-onset asthma developed. Patients with previous asthma or insomnia were excluded. The Poisson regression was used to estimate the incidence rate ratios (IRRs) and 95% CIs of asthma. Cox proportional hazard regression was used to calculate the risk of asthma between the two groups. RESULTS After a 4-year follow-up, 424 patients in the insomnia group and 409 in the control group developed asthma. The incidence rate of asthma was significantly higher in the insomnia group (22.01vs10.57 per 10 000 person-years). Patients with insomnia have a higher risk of developing new-onset asthma during the 4-year follow-up (HR: 2.08, 95% CI 1.82 to 2.39). The difference remained significant after adjustment (adjusted HR: 1.89, 95% CI 1.64 to 2.17). CONCLUSIONS This large population-based study suggests that insomnia at baseline is a risk factor for developing asthma.
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Affiliation(s)
- Yu-Chieh Lin
- Department of Family Medicine, Jiannren Hospital, Kaohsiung, Taiwan
| | - Chih-Cheng Lai
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan
| | - Chih-Chiang Chien
- Department of Internal Medicine, Chi Mei Medical Center, Yung Kang, Tainan, Taiwan
| | - Chin-Ming Chen
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shyh-Ren Chiang
- Department of Internal Medicine, Chi Mei Medical Center, Yung Kang, Tainan, Taiwan
- Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuo-Chen Cheng
- Department of Internal Medicine, Chi Mei Medical Center, Yung Kang, Tainan, Taiwan
- Department of Safety, Health, and Environmental Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan
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Abstract
Sleep problems are common in healthy young children, as well as in older children and adolescents with asthma; yet little is known about the sleep patterns and sleep issues of young children with asthma. Further, when young children have sleep disruptions, parental sleep is also typically disrupted. The purpose of this study was to characterize sleep in young children (one to four years) with and without asthma and their parents. Parents of young children ( n = 364) from the general community completed measures of sleep patterns and sleep issues in their children and in themselves. Compared to children with well-controlled asthma or no asthma, children with poorly controlled asthma had poorer sleep patterns, more difficulty falling asleep, and more sleep disruptions (i.e. restless sleep, frequent apneas and gasping during sleep, and frequent sleep terrors). Parents of children with poorly controlled asthma indicated their own sleep was regularly disrupted, and they had frequent night awakenings due to attending to, and stress caused by, their child's health needs. Children with poorly controlled asthma and their parents demonstrated significant sleep issues. Clinical implications for working with young children with asthma and their parents are discussed.
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Affiliation(s)
- Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, CO, USA
| | - Cara E Pugliese
- Department of Neuropsychology, Children’s National Health System, Washington, DC, USA
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Bian J, Guo Y, Xie M, Parish AE, Wardlaw I, Brown R, Modave F, Zheng D, Perry TT. Exploring the Association Between Self-Reported Asthma Impact and Fitbit-Derived Sleep Quality and Physical Activity Measures in Adolescents. JMIR Mhealth Uhealth 2017; 5:e105. [PMID: 28743679 PMCID: PMC5548986 DOI: 10.2196/mhealth.7346] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/18/2017] [Accepted: 07/04/2017] [Indexed: 12/31/2022] Open
Abstract
Background Smart wearables such as the Fitbit wristband provide the opportunity to monitor patients more comprehensively, to track patients in a fashion that more closely follows the contours of their lives, and to derive a more complete dataset that enables precision medicine. However, the utility and efficacy of using wearable devices to monitor adolescent patients’ asthma outcomes have not been established. Objective The objective of this study was to explore the association between self‑reported sleep data, Fitbit sleep and physical activity data, and pediatric asthma impact (PAI). Methods We conducted an 8‑week pilot study with 22 adolescent asthma patients to collect: (1) weekly or biweekly patient‑reported data using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures of PAI, sleep disturbance (SD), and sleep‑related impairment (SRI) and (2) real-time Fitbit (ie, Fitbit Charge HR) data on physical activity (F-AM) and sleep quality (F‑SQ). To explore the relationship among the self-reported and Fitbit measures, we computed weekly Pearson correlations among these variables of interest. Results We have shown that the Fitbit-derived sleep quality F-SQ measure has a moderate correlation with the PROMIS SD score (average r=−.31, P=.01) and a weak but significant correlation with the PROMIS PAI score (average r=−.18, P=.02). The Fitbit physical activity measure has a negligible correlation with PAI (average r=.04, P=.62). Conclusions Our findings support the potential of using wrist-worn devices to continuously monitor two important factors—physical activity and sleep—associated with patients’ asthma outcomes and to develop a personalized asthma management platform.
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Affiliation(s)
- Jiang Bian
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Yi Guo
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Mengjun Xie
- Department of Computer Science, University of Arkansas at Little Rock, Little Rock, AR, United States
| | - Alice E Parish
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Isaac Wardlaw
- Department of Computer Science, University of Arkansas at Little Rock, Little Rock, AR, United States
| | - Rita Brown
- Arkansas Children's Research Institute, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - François Modave
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Dong Zheng
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, United States
| | - Tamara T Perry
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Hospital, Arkansas Children's Research Institute, Little Rock, AR, United States
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Bakour C, O'Rourke K, Schwartz S, Wang W, Sappenfield W, Couluris M. Sleep duration, obesity, and asthma, in Florida adolescents: analysis of data from the Florida Youth Risk Behavior Survey (2009-2013). Sleep Breath 2017; 21:1039-1045. [PMID: 28093685 DOI: 10.1007/s11325-017-1460-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/06/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine the association between sleep duration and asthma among Florida high school students and whether body mass index (BMI) modifies this association. METHODS This cross-sectional analysis included 16,728 participants in the Florida Youth Risk Behavior Survey (2009-2013). Using logistic regression, we examined the association between sleep duration and asthma, and, after controlling for potential confounders, analyzed the interaction between sleep duration and BMI. RESULTS Sleeping for less than 7 h or more than 8 h on school night was associated with increased odds of current asthma. Compared with 7-8 h of sleep per night, sleeping for <7 h had an OR of 1.22 (95% CI 1.07, 1.40), while sleeping for ≥9 h had and OR of 1.31 (1.06, 1.63). When stratified by body mass index (BMI), these associations were significant only in overweight adolescents, with those sleeping for <7 or ≥9 h having approximately twice the odds of having current asthma (OR = 1.75 (1.45, 2.11) and OR = 2.00 (1.32, 3.02) respectively), compared with normal weight adolescents who slept for 7-8 h per night. CONCLUSION The association between sleep duration and asthma in adolescents is modified by BMI. Short and long sleep durations are associated with asthma in overweight adolescents while no significant association is seen in those with normal BMI.
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Affiliation(s)
- Chighaf Bakour
- College of Public Health, Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
| | - Kathleen O'Rourke
- College of Public Health, Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Skai Schwartz
- College of Public Health, Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Wei Wang
- College of Public Health, Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - William Sappenfield
- College of Public Health, Department of Community and Family Health & Chiles Center, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA
| | - Marisa Couluris
- College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
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Sheikh SI, Pitts J, Ryan-Wenger NA, Kotha K, McCoy KS, Stukus DR. Improved quality-of-life of caregivers of children with asthma through guideline-based management. J Asthma 2016; 54:768-776. [PMID: 27831828 DOI: 10.1080/02770903.2016.1258077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The quality of life (QOL) of caregivers of children with asthma may be related to children's responses to asthma management. AIM To evaluate change in QOL over time of caregivers of children with asthma through guideline-based management. DESIGN This was a 3-year prospective cohort study of children with asthma referred to our pediatric asthma center. Families completed Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), the Asthma Control Test™ (ACT), and reported the number of days/month of albuterol use and wheezing at each clinic visit. RESULTS We enrolled 143 children, ages 7-17 years (mean = 10.6 ± 2.9), 56.6% male, 70.6% Caucasian. Patients were managed by the same MD (n = 65,45.5%) or APN (n = 78,54.5%) over time. The mean total PACQLQ significantly increased over the 3-year period (F = 67.418, p < .001). Total scores at the first visit were 4.8 ± 1.6, which improved to 6.1 ± 1 at the 3-month follow-up visit. This improvement was sustained at the 1, 2, and 3-year clinic visits. PACQLQ emotional function (F = 60.798, p < .001) and activity limitation (F = 41.517, p < .001) domains significantly improved as well. PACQLQ scores were significantly associated with improved ACT scores (r = .37 to .47, p < .05), fewer days/month of albuterol use (r = -.25 to -.36., p < .05), and wheezing (r = -.28 to -.33, p < .05). There were no significant differences in PACQLQ, or asthma clinical outcome measures between MD and APN providers. CONCLUSION Use of National Asthma Education and Prevention Program (NAEPP) guidelines significantly improved QOL of caregivers of children with asthma and in asthma-related symptoms. Improvements over time were independent of type of providers.
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Affiliation(s)
- Shahid I Sheikh
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA.,c Section of Allergy & Immunology , Nationwide Children's Hospital , Columbus , OH , USA
| | - Judy Pitts
- b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - Nancy A Ryan-Wenger
- b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - Kavitha Kotha
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - Karen S McCoy
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA
| | - David R Stukus
- a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.,c Section of Allergy & Immunology , Nationwide Children's Hospital , Columbus , OH , USA
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Krietsch KN, Lawless C, Fedele DA, McCrae CS, Janicke DM. Influence of asthma status on sleep variability in overweight/obese youth. J Asthma 2016; 54:383-391. [PMID: 27485318 DOI: 10.1080/02770903.2016.1218010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Pediatric asthma and overweight/obesity (OV/OB) frequently co-occur and youth with both conditions exhibit poor sleep/bedtime habits. This study assessed differences in week-to-weekend bedtime/wake time variability among OV/OB youth with/without comorbid asthma, and tested whether variability predicted weekday sleep. METHODS OV/OB youth (n = 142; 28% comorbid asthma; 7-12 years) wore an Accelerometer for 5 days (2 weekend days), providing estimates of week-to-weekend bedtime/wake-time variability, weekday Total Sleep Time (TST), weekday time in bed (TIB), and weekday wake after sleep onset (WASO). RESULTS There were no demographic differences between groups beyond lower family income for the OV/OB+asthma group. The OV/OB+asthma group exhibited later weekday (mean OV/OB+asthma = 10:39 pm, mean OV/OB only = 10:30pm) and weekend (mean OV/OB+asthma = 11:41 pm, mean OV/OB only = 11:17pm) bedtimes, earlier weekday waketimes (mean OV/OB+asthma = 6:40 am, mean OV/OB only = 6:51 am), and similar weekend waketimes (mean OV/OB+asthma = 7:54 pm, mean OV/OB only = 7:52 pm. Univariate MANOVA follow-ups indicated a main effect of asthma group for week-to-weekend bedtime and waketime variability, with the OV/OB+asthma group evidencing approximately 30 minutes greater bedtime (OV/OB+asthma mean = 90 minutes) and waketime (OV/OB+asthma mean = 108 minutes) variability. Within the OV/OB+asthma group, greater waketime variability predicted fewer minutes of weekday TIB and WASO. Within the OV/OB only group, wake time variability predicted fewer minutes of weekday TIB. CONCLUSION Findings suggest that asthma status confers risk for more week-to-weekend variability among currently OV/OB youth, and that greater variability shortens the weekday sleep period. Further research on reasons for greater week-to-weekend sleep variability in asthma is needed.
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Affiliation(s)
- Kendra N Krietsch
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | - Casey Lawless
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | - David A Fedele
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
| | - Christina S McCrae
- b Department of Health Psychology , University of Missouri , Columbia , MO , USA
| | - David M Janicke
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA
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36
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Li Z, Thompson LA, Gross HE, Shenkman EA, Reeve BB, DeWalt DA, Huang IC. Longitudinal associations among asthma control, sleep problems, and health-related quality of life in children with asthma: a report from the PROMIS(®) Pediatric Asthma Study. Sleep Med 2016; 20:41-50. [PMID: 27318225 PMCID: PMC4913028 DOI: 10.1016/j.sleep.2015.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 12/07/2015] [Accepted: 12/15/2015] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Few studies have investigated the complex relationship among asthma control, sleep problems, and health-related quality of life (HRQOL) among children with asthma. This study aimed to test the longitudinal effect of asthma control status on asthma-specific HRQOL through the mechanism of nighttime sleep quality and daytime sleepiness. METHODS The Patient-Reported Outcomes Measurement Information System (PROMIS(®)) Pediatric Asthma Study included 229 dyads of asthmatic children and their parents with two years of follow-up for assessing the change in asthma control, sleep problems, and asthma-specific HRQOL. The Asthma Control and Communication Instrument was used to measure asthma control status. Nighttime sleep quality assessment was based on difficulty falling asleep and getting up, and sleep disturbance. The Iowa Pediatric Daytime Sleeping Scale was used to assess daytime sleepiness. The PROMIS Asthma Impact Scale was used to measure asthma-specific HRQOL. Multilevel structural equation modeling was performed to quantify the direct and indirect effects of asthma control status on asthma-specific HRQOL through nighttime sleep quality and daytime sleepiness. RESULTS Poorer asthma control status was directly associated with lower asthma-specific HRQOL at within-subject and between-subject levels (p < 0.05); however, effects of asthma control on asthma-specific HRQOL were indirectly influenced through daytime sleepiness at the within-subject level (p < 0.05), and through nighttime sleep quality and daytime sleepiness at the between-subject level (p < 0.05). CONCLUSIONS Asthma control status is associated with asthma-specific HRQOL, and this association is mediated by nighttime sleep quality and daytime sleepiness. Clinicians should address sleep problems related to asthma control to improve HRQOL for asthmatic children.
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Affiliation(s)
- Zheng Li
- College of Nursing and Health Professions, Valparaiso University, Valparaiso, IN, USA
| | - Lindsay A Thompson
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Heather E Gross
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Bryce B Reeve
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Darren A DeWalt
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
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Meltzer LJ, Faino A, Szefler SJ, Strand M, Gelfand EW, Beebe DW. Experimentally manipulated sleep duration in adolescents with asthma: Feasibility and preliminary findings. Pediatr Pulmonol 2015; 50:1360-7. [PMID: 25872769 PMCID: PMC4785884 DOI: 10.1002/ppul.23179] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 12/08/2014] [Accepted: 01/02/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To examine the impact of sleep duration on lung function and asthma symptoms in adolescents. METHODS Ten adolescents with asthma (60% female, 60% Caucasian, mean age = 13.7 years, range 12-17) completed a 3-week randomized, cross-over sleep manipulation protocol. Following a week of self-selected sleep duration, adolescents were randomized to a five-night deficient sleep opportunity (6.5 hr in bed) or a healthy sleep opportunity (10 hr in bed) obtained by systematically changing bedtimes. Wake time remained consistent across all 3 weeks (including weekends). Daily reports of sleep patterns and asthma symptoms, actigraphy, and daily peak expiratory flow rates (PEFR), as well as weekly spirometry and exhaled nitric oxide were collected. RESULTS Participants averaged 3.2 hr less sleep (P < 0.001) per night in the short sleep condition versus the long sleep condition. Further, they had an 8.4% decrease overnight in PEFR (P = 0.007), and reported more asthma symptoms interfering with activities in the past 24 hr (P = 0.02) in the short sleep condition than the long sleep condition. No significant differences between experimental weeks were found for weekly spirometry or exhaled nitric oxide. CONCLUSIONS This pilot study demonstrated the feasibility of a cross-over sleep manipulation protocol in adolescents with asthma. Since overnight decrease in PEFR is a marker of nocturnal asthma, and has been associated with the severity of daytime airflow limitation, these early-stage results suggest that shortened sleep duration may exacerbate adolescent asthma and associated functional impairments.
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Affiliation(s)
| | - Anna Faino
- National Jewish Health, Denver, Colorado
| | | | | | | | - Dean W Beebe
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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