Sleep disturbances in children with cystic fibrosis, primary ciliary dyskinesia and typically developing children during COVID-19 pandemic

Impact of COVID-19 in Children with Chronic Lung Diseases

BACKGROUND

since December 2019, the world has become victim of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The aim of our narrative review is to analyze the impact of COVID-19 in children suffering from chronic lung disease (CLD).

METHODS

we searched the MEDLINE/Pubmed database using the terms "SARS-CoV-2" or "COVID-19" or "Coronavirus Diseases 2019"; AND "chronic lung diseases" or "chronic respiratory diseases" or "asthma" or "cystic fibrosis" or "primary ciliary dyskinesia" or "bronchopulmonary dysplasia"; and limiting the search to the age range 0-18 years.

RESULTS AND CONCLUSIONS

although COVID-19 rarely presents with a severe course in children, CLD may represent a risk factor; especially when already severe or poorly controlled before SARS-CoV-2 infection. On the other hand, typical features of children with CLD (e.g., the accurate adoption of prevention measures, and, in asthmatic patients, the regular use of inhaled corticosteroids and T2 inflammation) might have a role in preventing SARS-CoV-2 infection. Moreover, from a psychological standpoint, the restrictions associated with the pandemic had a profound impact on children and adolescents with CLD.

Sleep of infants and toddlers during 12 months of the COVID-19 pandemic in the midwestern United States

STUDY OBJECTIVES

Cultural sleep practices and COVID-19 mitigation strategies vary worldwide. The sleep of infants and toddlers during the COVID-19 pandemic in the United States (US) is understudied.

METHODS

Caregivers of children aged <3 years responded to a cross-sectional survey during 2020 (divided into quarters, with year quarter 1 largely pre-lockdown). We assessed the global effect of year quarter on parent-reported total sleep time (TST, hours) and sleep onset latency (SOL, hours) using ANOVA. We used multivariable linear regression to assess the adjusted effect of year quarter on TST, SOL and parental frustration. We used logistic regression to assess the adjusted effect of year quarter on nap consistency.

RESULTS

Of 594 children, mean age was 18.5±9.7 months; 52% were female. In the adjusted analyses, the reference categories were: quarter 1 (year quarter); ≤6 months (age category); <$25,000 (household income). TST was associated with age category (12 to ≤24 month: β=-2.86;p=0.0004, 24 to ≤36 month: β=-3.25;p<0.0001), and maternal age (β=-0.04;p=0.05). SOL was associated with year quarter (year quarter 3: β=0.16; p =0.04), age category (24 to ≤36 months: β=0.28;p<0.0001), household income ($100,000-150,000: β =-0.15;p=0.03, >$150,000: β=-0.19;p=0.01) and lack of room sharing (β=-0.09; p=0.05). Parental frustration with sleep increased with age (all p<0.05) and lack of room sharing (p=0.01). The effect of lack of room sharing on nap consistency approached significance (aOR 1.88;95%CI 0.95, 3.72).

CONCLUSIONS

Social factors such as lower household income and room sharing affected the sleep of US infants and toddlers as opposed to the COVID-19 lockdown itself.