0520 Effect Of Sleep Disordered Breathing On Control And Severity Of Asthma On Pediatric Population

Abstract

Abstract Introduction Pediatric sleep disordered breathing (SDB) can co-exist with asthma, affecting its control and severity, adding to the overall health care burden. Our aim was to determine the association of SDB with control and severity of asthma, and to evaluate any concomitant risk factors associated with both. Methods Based on the Sleep-Related Breathing Disorder scale extracted from the Pediatric Sleep Questionnaire (SDBS-PSQ), children (5 – 15 years) with persistent asthma were classified as: with SDB (SDBS-PSQ ≥ 0.33) and without SDB, in a cross – sectional study. Characteristics like age, gender, body mass index and spirometry were compared. Control of asthma was categorized into well-controlled, not-well, and poorly controlled using childhood – asthma control test (c-ACT ≥20, 12-19 and ≤12, respectively). Correlation between SDBS-PSQ and c-ACT was analysed. Correlation of risk factors like adeno-tonsillar hypertrophy, gastroesophageal reflux disease, obesity and allergic rhinitis (AR) with presence of SDB in asthma was also assessed. Results Among sixty asthmatics, mild, moderate, and severe persistent asthma was observed in 26.67%, 40% and 33.33%, respectively. 18.33% asthmatics had risk for SDB (mean SDBS-PSQ of 0.45 ± 0.11 vs 0.07 ± 0.07 in those without SDB, p<0.001). Baseline and spirometric characteristics were similar in both groups. Asthmatics with SDB had higher rates of severe persistent (63.6% vs 26.5%, p = 0.018) and uncontrolled asthma (100% vs 30.6%, p<0.001), and a lower mean c–ACT score (14.45 ± 3.20 vs 20.04 ± 4.56, p<0.001) compared to asthmatics without SDB. Amongst asthmatics with SDB, mean SDBS-PSQ score was higher in not-well and poorly controlled asthmatics (0.41 ± 0.07 vs 0.12 ± 0.08, p <0.001 and 0.58 ± 0.08 vs 0.01 ± 0.07, p<0.001; respectively), compared to those without SDB. Negative correlation was confirmed between c-ACT and SDBS-PSQ scores (p<0.001, r2 = 0.36). Only AR was associated with SDB (p = 0.001, correlation coefficient <0.001). Conclusion Control and severity of asthma is adversely affected by SDB, independent of other risk factors. AR can increase the risk of SDB in asthmatic children, further affecting the control. Therefore, children with severe and difficult-to-control asthma should be screened for SDB using objective questionnaires like SDBS-PSQ. Support (If Any) Nil