Sleep-disordered Breathing is Associated with Asthma Severity in Children

Overview

Journal J Pediatr

Specialty Pediatrics

Date 2011 Dec 3

PMID 22133422

Citations 47

Authors

Kristie R Ross

Amy Storfer-Isser

Meeghan A Hart

Anna Marie V Kibler

Michael Rueschman

Carol L Rosen

Carolyn M Kercsmar

Susan Redline

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the relationships among obesity, sleep-disordered breathing (SDB, defined as intermittent nocturnal hypoxia and habitual snoring), and asthma severity in children. We hypothesized that obesity and SDB are associated with severe asthma at a 1- year follow-up.

Study Design: Children aged 4-18 years were recruited sequentially from a specialty asthma clinic and underwent physiological, anthropometric, and biochemical assessment at enrollment. Asthma severity was determined after 1 year of follow-up and guideline-based treatment, using a composite measure of level of controller medication, symptom burden, and health care utilization. Multivariate logistic regression was used to examine adjusted associations of SDB and obesity with asthma severity at 12-month follow-up.

Results: Among 108 subjects (mean age, 9.1±3.4 years; 45.4% African-American; 67.6% male), obesity and SDB were common, affecting 42.6% and 29.6% of subjects, respectively. After adjusting for obesity, race, and sex, children with SDB had a 3.62-fold increased odds of having severe asthma at follow-up (95% CI, 1.26-10.40). Obesity was not associated with asthma severity.

Conclusion: SDB is a modifiable risk factor for severe asthma after 1 year of specialty asthma care. Further studies are needed to determine whether treating SDB improves asthma morbidity.

Citing Articles

Mutual Influence Between Allergic Rhinitis and Sleep: Factors, Mechanisms, and interventions-A Narrative Review.

Yang T, Wang H, Mou Y, Liu W, Wang Y, Song X Nat Sci Sleep. 2024; 16:1451-1467.

PMID: 39318396 PMC: 11420902. DOI: 10.2147/NSS.S482258.

Exploring the Relationship between Inhaled Corticosteroid Usage, Asthma Severity, and Sleep-Disordered Breathing: A Systematic Literature Review.

Zaffanello M, Ferrante G, Piazza M, Nosetti L, Tenero L, Piacentini G Adv Respir Med. 2024; 92(4):300-317.

PMID: 39194421 PMC: 11352062. DOI: 10.3390/arm92040029.

Habitual snoring coexisting with respiratory allergies in children: Prevalence and impact on quality of life extending beyond primary snoring.

Ittiporn S, Angsubhakorn A, Tangkanangnukul C, Prajongdee K World Allergy Organ J. 2024; 17(8):100913.

PMID: 39176286 PMC: 11340495. DOI: 10.1016/j.waojou.2024.100913.

Evaluation of Sleep Quality in Asthmatic Children with the Paediatric Sleep Questionnaire (PSQ).

Ozkars M, Cevik S, Ata S, Sarisaltik A, Altas U Children (Basel). 2024; 11(6).

PMID: 38929307 PMC: 11202190. DOI: 10.3390/children11060728.

A comparison of caregiver-reported snoring and objective snoring in children from urban neighborhoods.

Yu P, Li X, Sofer T, Cunningham A, Owens J, Gold D Am J Otolaryngol. 2024; 45(4):104264.

PMID: 38696893 PMC: 11194994. DOI: 10.1016/j.amjoto.2024.104264.

References

Zhang L, Mendoza-Sassi R, Cesar J, Chadha N . Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy. Cochrane Database Syst Rev. 2008; (3):CD006286. PMC: 8923350. DOI: 10.1002/14651858.CD006286.pub2. View

Sulit L, Storfer-Isser A, Rosen C, Kirchner H, Redline S . Associations of obesity, sleep-disordered breathing, and wheezing in children. Am J Respir Crit Care Med. 2004; 171(6):659-64. DOI: 10.1164/rccm.200403-398OC. View

Brouillette R, Manoukian J, Ducharme F, Oudjhane K, Earle L, Ladan S . Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr. 2001; 138(6):838-44. DOI: 10.1067/mpd.2001.114474. View

Ten Brinke A, Sterk P, Masclee A, Spinhoven P, Schmidt J, Zwinderman A . Risk factors of frequent exacerbations in difficult-to-treat asthma. Eur Respir J. 2005; 26(5):812-8. DOI: 10.1183/09031936.05.00037905. View

Ford E . The epidemiology of obesity and asthma. J Allergy Clin Immunol. 2005; 115(5):897-909. DOI: 10.1016/j.jaci.2004.11.050. View

Fantuzzi G . Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol. 2005; 115(5):911-9. DOI: 10.1016/j.jaci.2005.02.023. View

Li J, Savransky V, Nanayakkara A, Smith P, ODonnell C, Polotsky V . Hyperlipidemia and lipid peroxidation are dependent on the severity of chronic intermittent hypoxia. J Appl Physiol (1985). 2006; 102(2):557-63. DOI: 10.1152/japplphysiol.01081.2006. View

Sood A, Qualls C, Seagrave J, Stidley C, Archibeque T, Berwick M . Effect of specific allergen inhalation on serum adiponectin in human asthma. Chest. 2008; 135(2):287-294. PMC: 3623933. DOI: 10.1378/chest.08-1705. View

Al-Shawwa B, Al-Huniti N, Titus G, Abu-Hasan M . Hypercholesterolemia is a potential risk factor for asthma. J Asthma. 2006; 43(3):231-3. DOI: 10.1080/02770900600567056. View

10.

Stradling J, Thomas G, Warley A, Williams P, Freeland A . Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Lancet. 1990; 335(8684):249-53. DOI: 10.1016/0140-6736(90)90068-g. View

11.

Shore S, Terry R, Flynt L, Xu A, Hug C . Adiponectin attenuates allergen-induced airway inflammation and hyperresponsiveness in mice. J Allergy Clin Immunol. 2006; 118(2):389-95. DOI: 10.1016/j.jaci.2006.04.021. View

12.

Sin D, Man S . Impaired lung function and serum leptin in men and women with normal body weight: a population based study. Thorax. 2003; 58(8):695-8. PMC: 1746780. DOI: 10.1136/thorax.58.8.695. View

13.

Ross K, Hart M, Storfer-Isser A, Kibler A, Johnson N, Rosen C . Obesity and obesity related co-morbidities in a referral population of children with asthma. Pediatr Pulmonol. 2009; 44(9):877-84. PMC: 2940418. DOI: 10.1002/ppul.21065. View

14.

de la Eva R, Baur L, Donaghue K, Waters K . Metabolic correlates with obstructive sleep apnea in obese subjects. J Pediatr. 2002; 140(6):654-9. DOI: 10.1067/mpd.2002.123765. View

15.

Tan K, Chow W, Lam J, Lam B, Wong W, Tam S . HDL dysfunction in obstructive sleep apnea. Atherosclerosis. 2005; 184(2):377-82. DOI: 10.1016/j.atherosclerosis.2005.04.024. View

16.

Evans 3rd R, Mullally D, Wilson R, Gergen P, Rosenberg H, Grauman J . National trends in the morbidity and mortality of asthma in the US. Prevalence, hospitalization and death from asthma over two decades: 1965-1984. Chest. 1987; 91(6 Suppl):65S-74S. View

17.

Kheirandish-Gozal L, Gozal D . Intranasal budesonide treatment for children with mild obstructive sleep apnea syndrome. Pediatrics. 2008; 122(1):e149-55. DOI: 10.1542/peds.2007-3398. View

18.

McFadden Jr E, Nelson J, Skowronski M, Lenner K . Thermally induced asthma and airway drying. Am J Respir Crit Care Med. 1999; 160(1):221-6. DOI: 10.1164/ajrccm.160.1.9810055. View

19.

FREED A, Davis M . Hyperventilation with dry air increases airway surface fluid osmolality in canine peripheral airways. Am J Respir Crit Care Med. 1999; 159(4 Pt 1):1101-7. DOI: 10.1164/ajrccm.159.4.9802072. View

20.

Kirk V, Bohn S, Flemons W, Remmers J . Comparison of home oximetry monitoring with laboratory polysomnography in children. Chest. 2003; 124(5):1702-8. DOI: 10.1378/chest.124.5.1702. View