Koinis-Mitchell Daphne, Kopel Sheryl J, Boergers Julie, Ramos Kara, LeBourgeois Monique, McQuaid Elizabeth L, Esteban Cynthia A, Seifer Roald, Fritz Gregory K, Klein Robert
Bradley/Hasbro Children's Research Center, The Warren Alpert Medical School of Brown University, Providence, RI.
J Clin Sleep Med. 2015 Jan 15;11(2):101-10. doi: 10.5664/jcsm.4450.
In this study, we examine the association of asthma (asthma symptoms, asthma control, lung function) and sleep problems in a group of urban children. The role of allergic rhinitis (AR), a comorbid condition of asthma, on children's sleep problems is also examined. Finally, we investigate whether sleep hygiene moderates the association between asthma and sleep problems, and whether there are differences in these associations based on ethnic background.
Non-Latino White, Latino, and African American urban children with asthma (n = 195) ages 7-9 (47% female) and their primary caregivers participated in a baseline visit involving interview-based questionnaires on demographics, asthma and rhinitis control, and caregiver report of children's sleep problems and sleep hygiene. Children and their caregivers participated in a clinical evaluation of asthma and AR, followed by a month monitoring period of children's asthma using objective and subjective methods.
Total sleep problem scores were higher in children of the sample who were from African American and Latino backgrounds, compared to non-Latino white children. Poor asthma control was predictive of higher levels of sleep problems in the entire sample. Poorer AR control also was related to more sleep problems, over and above children's asthma in the sample. This association was more robust in non-Latino white children. Poor sleep hygiene heightened the association between poor asthma control and sleep problems in the entire sample and in African American children.
Multidisciplinary interventions integrating the co-management of asthma, AR, and the effects of both illnesses on children's sleep, need to be developed and tailored to children and their families' ethnic background.
在本研究中，我们考察了一组城市儿童中哮喘（哮喘症状、哮喘控制情况、肺功能）与睡眠问题之间的关联。同时也考察了哮喘的合并症——过敏性鼻炎（AR）对儿童睡眠问题的作用。最后，我们探究了睡眠卫生习惯是否会调节哮喘与睡眠问题之间的关联，以及这些关联在不同种族背景下是否存在差异。
7至9岁患有哮喘的非拉丁裔白人、拉丁裔和非裔美国城市儿童（n = 195，47%为女性）及其主要照料者参与了一次基线访视，其中包括基于访谈的关于人口统计学、哮喘和鼻炎控制情况的问卷，以及照料者对儿童睡眠问题和睡眠卫生习惯的报告。儿童及其照料者参与了哮喘和AR的临床评估，随后通过客观和主观方法对儿童哮喘进行了为期一个月的监测。
与非拉丁裔白人儿童相比，来自非裔美国和拉丁裔背景的样本儿童的总睡眠问题得分更高。在整个样本中，哮喘控制不佳预示着睡眠问题水平更高。在样本中，AR控制不佳也与更多睡眠问题有关，且超出了儿童哮喘的影响。这种关联在非拉丁裔白人儿童中更为显著。睡眠卫生习惯差加剧了整个样本以及非裔美国儿童中哮喘控制不佳与睡眠问题之间的关联。
需要制定多学科干预措施，综合管理哮喘、AR以及这两种疾病对儿童睡眠的影响，并根据儿童及其家庭的种族背景进行调整。
