Children With Asthma Have Greater Risk of Sleep-Disordered Breathing

Children with severe and poorly controlled asthma generally face a greater risk of sleep-disordered breathing.

A version of this article was originally published on HCPLive. This version has been lightly edited.

A recent study presented at the SLEEP 2022 Annual Meeting showed that sleep-disordered breathing is more frequent in children with asthma than in the general population.

The findings also highlighted a viable screening tool that could help clinicians interpret and initiate care on sleep-disordered breathing in higher risk groups including pediatric patients with asthma.

A team of investigators from the Employees' State Insurance Post Graduate Institute of Medical Sciences & Research in India conducted an assessment of the risk factors and prevalence of sleep-disordered breathing in children with asthma versus those without; they additionally sought to describe the polysomnographic parameters of asthmatics with sleep-disordered breather.

As they noted, children with severe and poorly controlled asthma generally face a greater risk of sleep-disordered breathing, with worse consequences.

“It can lead to cardiovascular, neurocognitive, and behavioral problems,” investigators wrote. “Variable data exists currently whether demographic factors like age, sex, obesity, adeno-tonsillar hypertrophy tend to increase the risk of sleep-disordered breathing in asthmatics.”

The team recruited children with and without asthma aged 5-15 years old to participate in the case-control trial. Characteristics including age, gender, body mass index (BMI), adeno-tonsillar hypertrophy, and history of snoring were collected at baseline and compared.

Trial participants completed the Sleep-Related Breathing Disorder scale, a 22-item symptom questionnaire derived from the Pediatric Sleep Questionnaire (SDBS-PSQ) that defines scores based on mean response of non-missing items answered yes (1) or no (0). Investigators sought the prevalence of sleep-disordered breathing risk, defined as ≥0.33 score on the scale.

Additionally, a subset of children with asthma and risk of sleep-disordered breathing underwent polysomnography; they were then classified into no, mild, moderate or severe disease based on apnea-hypopnea index (AHI) score.

The assessment included 120 children, of whom 60 were asthmatic. Among the asthma group, nearly two-thirds (61.7%) were male; mean patient age was 9.51 years old. Mean questionnaire score among the group of children with asthma was 0.14, versus the control group mean score of 0.05 (P = .001). Children with asthma were nearly 11-fold more likely to be diagnosed with sleep-discorded breathing (18.33% vs 1.67%; P = .001).

Children with asthma were also more than twice likely to report a history of snoring (25.0%) versus controls (11.7%), while otherwise reporting similar characteristics (P >.05).

Investigators observed 11 children with asthma at risk of sleep-disordered breathing; 10 underwent polysomnography, and 9 were diagnosed with the condition. Mean AHI score among them was 4.21, while mean total sleep time was 279.23 minutes nightly and a mean arousal index of 10.23.

Indeed, the investigators concluded their findings support the suggested risk of sleep-disordered breathing in children with asthma versus those without.

“SDBS-PSQ is a useful screening tool for diagnosing sleep-disordered breathing and should be incorporated in the daily practice, the gold standard being polysomnography,” they wrote. “Further studies would help in a better understanding of sleep-disordered breathing spectrum in children.”

The study, “Prevalence and Severity of Sleep Disordered Breathing in Asthmatic Children,” was presented at SLEEP 2022.

Reference

Singla A, Bagla J, Gothi D, et al. Effect of sleep disordered breathing on control and severity of asthma on pediatric population. Presented at: SLEEP 2022; June 4-8, 2022; Charlotte, North Carolina. Abstract 0520.