Pediatric Pulmonary and Sleep Unit, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Division of Pulmonary Medicine and Cystic Fibrosis Center, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New-Jersey, USA.
Pediatr Pulmonol. 2022 Aug;57(8):1851-1859. doi: 10.1002/ppul.25264. Epub 2021 Mar 1.
Asthma and sleep disorders are both common in childhood, and often co-exist in the same child. Moreover, studies have shown that in many children the rate of one is influenced by the other. Sleep disorders can be classified into six different groups-insomnia, hypersomnia, parasomnia, movement disorders, circadian disorders, and sleep-related breathing disorders. Children with asthma often present with complaints of insomnia with poor sleep quality, difficulty falling asleep and sleep disruptions. These complains are often associated with asthma control. They may also complain of daytime sleepiness and have higher rates of parasomnias, such as night terrors and nocturnal enuresis when compared with their healthy peers. Whether movement and circadian disorders are also more prevalent in children with asthma is less clear. Finally, there is a complex bidirectional interaction between sleep-related breathing disorders and asthma: poor sleep and sleep disorders may worsen asthma, and asthma, particularly when it is poorly controlled, may impair sleep. In the current review we examine the association of each of the sleep disorders with asthma and review the common pathophysiological pathways. We hope to convince the reader that appropriate management of asthma must include inquiries into the patient's sleep, and vice versa.
哮喘和睡眠障碍在儿童中都很常见，并且经常同时存在于同一个孩子身上。此外，研究表明，在许多儿童中，一种疾病的发生率受另一种疾病的影响。睡眠障碍可以分为六大类——失眠、嗜睡、睡眠相关行为障碍、睡眠运动障碍、昼夜节律紊乱和睡眠呼吸障碍。哮喘患儿常出现睡眠质量差、入睡困难和睡眠中断等失眠症状。这些症状通常与哮喘控制有关。他们还可能抱怨白天嗜睡，并且与健康同龄人相比，他们发生睡眠相关行为障碍（如夜惊和夜间遗尿）的几率更高。运动和昼夜节律紊乱是否在哮喘儿童中也更为常见尚不清楚。最后，睡眠呼吸障碍和哮喘之间存在着复杂的双向相互作用：睡眠质量差和睡眠障碍可能会使哮喘恶化，而哮喘，尤其是当哮喘控制不佳时，可能会影响睡眠。在本次综述中，我们检查了每种睡眠障碍与哮喘的关联，并综述了常见的病理生理途径。我们希望能让读者相信，哮喘的合理治疗必须包括对患者睡眠的询问，反之亦然。
