1. Asthma and sleep disordered breathing in the pediatric adenotonsillectomy trial for snoring study.
- Author
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Tsou PY, Gueye-Ndiaye S, Gorman KL, Williamson A, Ibrahim S, Weber S, Zopf D, Hassan F, Baldassari C, Sendon C, Wang R, Redline S, Li D, and Ross KR
- Subjects
- Child, Child, Preschool, Female, Humans, Male, Cross-Sectional Studies, Polysomnography, Quality of Life, Risk Factors, Severity of Illness Index, Sleep Apnea Syndromes epidemiology, Sleep Apnea Syndromes diagnosis, Sleep Apnea Syndromes surgery, Adenoidectomy, Asthma epidemiology, Asthma diagnosis, Snoring surgery, Snoring epidemiology, Tonsillectomy
- Abstract
Purpose: Although asthma is common in children with sleep-disordered breathing (SDB), it is unclear whether and to what extent asthma is associated with SDB-related outcomes. Our objectives are to describe risk factors for asthma among children with mild SDB (mSDB) and assess the association between asthma and the severity of sleep-related outcomes., Methods: Cross-sectional analyses were conducted for children aged 3-12.9 years with mSDB enrolled in Pediatric Adenotonsillectomy for Snoring Children Study. Sleep-related outcomes included SDB symptoms (Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder scale (PSQ-SRBD)), SDB-specific quality of life (OSA-18), sleepiness (modified Epworth Sleepiness Score) and polysomnographic and actigraphic measures. Asthma was defined by caregiver-reported diagnosis with current asthma symptoms and medication use, or a Composite Asthma Severity Index (CASI) score ≥ 4. Asthma was further categorized into mild (CASI < 4) and moderate-to-severe (CASI ≥ 4). Regression analyses were conducted to identify asthma risk factors and estimate the associations between mild and moderate-to-severe asthma with sleep-related outcomes., Results: The sample included 425 children (20.3%-Black, 17.4%-Hispanic; 51.7%-female). The prevalence of asthma was 19.1% (7.1% moderate-to-severe, 12.0% mild). Environmental tobacco smoke exposure and markers of atopy were associated with asthma in multivariable-adjusted analyses. Moderate-to-severe asthma was associated with increased OSA symptoms measured by PSQ-SRBD (adjusted effect estimate for moderate-to-severe vs. no asthma ( β ^
adj ; 95%CI): 0.08; 0.01, 0.15)) and decreased quality of life measured by OSA-18 ( β ^adj ; 95%CI: 7.5; 1.20, 13.82)), and a small increase in the arousal index ( β ^adj ; 95%CI: 0.80; 0.09, 1.51))., Conclusion: Moderate-to-severe asthma was associated with worse QoL and greater SDB symptoms among children with mSDB. The co-occurrence of common risk factors for mSDB and asthma and worse symptoms and quality of life in children with both conditions support coordinated strategies for prevention and co-management of both disorders., Clinical Trial: Pediatric Adenotonsillectomy for Snoring (PATS), NCT02562040, https://clinicaltrials.gov/study/NCT02562040., Competing Interests: Declarations. Human and animal rights and informed consent: All procedures performed in studies involving human participants were in accordance with the ethical standards of each site participating in PATS and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the institutional review board at each site. Written informed consent was obtained from caregivers and assent from children older than 7 or 8 years (according to each site’s local requirements). Conflict of interest: Dr. Redline reports consulting fees from Apnimed Inc, Eli Lilly and Jazz Pharma, unrelated to this study., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)- Published
- 2024
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