Variability of peak flow in wheezy children.

A study of peak flow variability was carried out among a population sample of 63 wheezy children aged 9-11 years. Recordings were made over 12 days at three times during the day--first thing in the morning, on returning home from school and at bedtime. Eighty nine per cent of the children had symptoms during the diary period. The mean amplitude (difference between the highest and lowest daily peak flow values) was 17% of the mean daily value (range 4-48%). By cosinor analysis the amplitude was 12% of the mean value (range 1-53%). In 65% of the children the lowest point of the daily rhythm as determined by cosinor analysis lay between midnight and 8am; the rhythm was, however, statistically significant in only fourteen individuals (22%). These levels of variability are considerably lower than those previously reported in hospital based studies of adult asthmatics. As a method of demonstrating variable airflow obstruction, which is the defining physiological characteristic of asthma, the use of a peak flow diary alone appears to be of limited value in children.