Sleep problems in childhood asthma ‘need greater attention’
medwireNews: Clinicians must do more to address sleep problems in children with asthma, say researchers who found that daytime sleepiness significantly mediates the relationship between poor asthma control and impaired asthma-specific health-related quality of life (HRQoL).
"It appears that a substantial part of the relationship between asthma control and HRQOL is a consequence of sleep concerns," say study authors I-Chan Huang (University of Florida, Gainesville, USA) and colleagues.
"This insight emphasizes the importance of assessing nighttime symptoms and daytime sleepiness by clinicians as an important element of managing pediatric asthma."
In all, 51.9% of 160 children aged 8-17 years had a poor asthma control status, according to the Asthma Control and Communication Instrument, and this was significantly associated with asthma-specific HRQoL, after adjusting for confounders.
And, two of four daytime sleepiness domains of the Cleveland Adolescent Sleepiness Questionnaire (CASQ) - sleep in school and sleep in evening - were also significantly associated with impaired asthma-specific HRQoL.
The authors found that approximately 43% of the total variance in the association between asthma control and asthma-specific HRQoL was explained by the indirect effects of daytime sleepiness. In particular, the sleep in school and sleep in evening components of the CASQ were significantly associated with the indirect effects of asthma control on asthma-related HRQoL.
"This finding implies that daytime sleepiness plays an important role in mediating the relationship between asthma control status and asthma-specific HRQOL," comment Huang and colleagues.
Writing in Sleep Medicine, they say that while electrophysiologic techniques are the gold standard for assessing sleep quality, self-report instruments are also useful. Appropriate use of controller medication can help improve sleeping difficulties in children with asthma, they note. Additionally, approaches to reduce exposure to allergens such as dust mites in bed may be effective.
"Interventions based on physiologic, psychologic, and behavioral perspectives might be useful to address nighttime sleep difficulties and daytime sleepiness issues faced by children who frequently have poor asthma control status," they conclude.
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By Kirsty Oswald, medwireNews Reporter