Department of Pediatrics and the Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
Acad Pediatr. 2011 Nov-Dec;11(6):493-9. doi: 10.1016/j.acap.2011.05.006. Epub 2011 Aug 3.
The aim of this study was to describe nocturnal asthma symptoms among urban children with asthma and assess the burden of sleep difficulties between children with varying levels of nocturnal symptoms.
We analyzed baseline data from 287 urban children with persistent asthma (aged 4-10 years) enrolled in the School-Based Asthma Therapy trial; Rochester, New York. Caregivers reported on nocturnal asthma symptoms (number of nights/2 weeks with wheezing or coughing), parent quality of life (Juniper's Pediatric Asthma Caregivers Quality of Life Questionnaire), and sleep quality by using the validated Children's Sleep Habits Questionnaire. We used bivariate and multivariate statistics to compare nocturnal asthma symptoms with sleep quality/quantity and quality of life.
Most children (mean age, 7.5 years) were black (62%); 74% had Medicaid. Forty-one percent of children had intermittent nocturnal asthma symptoms, 23% mild persistent, and 36% moderate to severe. Children's average total sleep quality score was 51 (range, 33-99) which is above the clinically significant cutoff of 41, indicating pervasive sleep disturbances among this population. Sleep scores were worse for children with more nocturnal asthma symptoms compared with those with milder symptoms on total score, as well as several subscales, including night wakings, parasomnias, and sleep disordered breathing (all P < .03). Parents of children with more nocturnal asthma symptoms reported their child having fewer nights with enough sleep in the past week (P = .018) and worse parent quality of life (P < .001).
Nocturnal asthma symptoms are prevalent in this population and are associated with poor sleep quality and worse parent quality of life. These findings have potential implications for understanding the disease burden of pediatric asthma.
本研究旨在描述城市哮喘儿童的夜间哮喘症状，并评估不同夜间症状水平儿童的睡眠困难负担。
我们分析了罗切斯特市（纽约州）基于学校的哮喘治疗试验中 287 名持续性哮喘（年龄 4-10 岁）的城市儿童的基线数据。护理人员报告了夜间哮喘症状（喘息或咳嗽的夜间/2 周次数）、父母生活质量（Juniper 儿童哮喘护理人员生活质量问卷）以及使用验证后的儿童睡眠习惯问卷的睡眠质量。我们使用双变量和多变量统计来比较夜间哮喘症状与睡眠质量/数量和生活质量。
大多数儿童（平均年龄 7.5 岁）为黑人（62%）；74%的儿童拥有医疗补助。41%的儿童有间歇性夜间哮喘症状，23%有轻度持续性症状，36%有中度至重度症状。儿童的总睡眠质量平均得分为 51（范围 33-99），高于 41 的临床显著分界值，表明该人群普遍存在睡眠障碍。与症状较轻的儿童相比，夜间哮喘症状更多的儿童的总得分以及包括夜醒、睡眠障碍呼吸暂停和睡眠障碍呼吸暂停在内的几个亚量表的睡眠评分更差（所有 P<.03）。夜间哮喘症状较多的儿童的父母报告称，他们的孩子在过去一周内睡眠不足的夜晚更少（P=0.018），且父母生活质量更差（P<.001）。
夜间哮喘症状在该人群中很常见，与睡眠质量差和父母生活质量差有关。这些发现对了解儿科哮喘的疾病负担具有潜在意义。
