Uncontrolled asthma raises odds for sleep-disordered breathing in children

Key takeaways:

• Among 78 asthmatic children, 29.5% had uncontrolled asthma.
• Asthmatic children with vs. without sleep-disordered breathing had lower health-related quality of life scores.

Having uncontrolled asthma significantly heightened a child’s odds for sleep-disordered breathing, according to results published in Respiratory Medicine.

“Our results confirmed an association between [sleep-disordered breathing] and the risk of uncontrolled asthma, consistent with current GINA recommendations for the screening for [sleep-disordered breathing] in children affected by difficult-to-control asthma,” Cristian Locci, MD, of the department of medicine, surgery and pharmacy at the University of Sassari in Italy, and colleagues wrote.

In a cross-sectional study, Locci and colleagues assessed 78 children (median age, 10 years; 59% boys) with asthma aged 5 to 12 years to find out how prevalent sleep-disordered breathing is in this patient population through the Pediatric Sleep Questionnaire (PSQ) and how this condition is linked to asthma control, found via the Childhood Asthma Control Test (C-ACT).

Researchers also collected data on quality of life using the Pediatric Quality of Life Inventory (PedsQL) questionnaire. Scores ranged from 0 to 100, and lower scores signaled poorer health-related quality of life.

Of the total cohort, 37.2% (n = 29) had sleep-disordered breathing, and uncontrolled asthma, indicated by a C-ACT score of 19 or less, appeared in a significantly greater proportion of these children vs. children without sleep-disordered breathing (48.3% vs. 18.4%; P = .005).

Between the two sets of children, the median C-ACT score was worse among those with sleep-disordered breathing (20 vs. 23; P = .004), suggesting poorer asthma control.

Researchers additionally observed a significant link between uncontrolled asthma and heightened odds for sleep-disordered breathing (OR = 4.15; 95% CI, 1.49-11.6) in univariate analysis.

In terms of quality of life, children with sleep-disordered breathing had a median PedsQL score of 75, whereas children without this condition had a higher median score of 82.6 (P < .0001).

There was a significant link between PedsQL score and a reduced likelihood for sleep-disordered breathing in both the univariate analysis (OR = 0.93; 95% CI, 0.88-0.97) and the multivariate analysis (OR = 0.94; 95% CI, 0.9-0.99), according to researchers.

Within the total cohort, most children had well-controlled asthma (70.5%; n = 55) as opposed to uncontrolled asthma (29.5%; n = 23). In the uncontrolled asthma cohort, 60.9% had sleep-disordered breathing, which was significantly greater than the 27.3% of children in the well-controlled asthma cohort with this condition (P = .005).

Following suit, children with uncontrolled vs. well-controlled asthma had increased median PSQ-sleep disordered breathing subscale scores, which researchers wrote signal a higher probability of sleep-disordered breathing (0.36 vs. 0.19; P = .0009).

Lastly, children with uncontrolled asthma had a median PedsQL score of 72.8, whereas children with well-controlled asthma had a higher median score of 81.5 (P = .0004).

“Children with uncontrolled asthma and frequent nocturnal attacks should be screened for [sleep-disordered breathing] with PSQ and possibly referred to PSG to assess an underlying OSA,” Locci and colleagues wrote. “On the other hand, clinical evaluation for asthma, including spirometry, should be taken into consideration in children affected by severe [sleep-disordered breathing].”