Abstract

Background: Previous studies have linked allergic symptoms to sleep in children, but the associations might be different when considering different types of allergic symptoms or sleep outcomes. Moreover, the combined effects of multiple allergic symptoms remain unclear in early life. This study aimed to investigate the associations between multiple allergic symptoms and sleep outcomes in early life.Methods: We included 673 toddlers aged 2 years from a birth cohort in Guangzhou, China. We identified allergic symptoms (skin, eyes and nose, gastrointestinal tract, mouth and lips, and wheeze) within 2 years via standard questionnaires. Sleep outcomes including sleep duration and quality over the past month were assessed based on the Chinese version of the Brief Infant Sleep Questionnaire. Associations between allergic symptoms and sleep outcomes were examined using multivariable linear regression and logistic regression.Results: Compared to children without allergic symptoms, children with allergic nasal and ocular symptoms had higher odds of frequent nighttime awakenings (OR = 1.41; 95% CI: 1.03, 1.93) and irregular sleep (OR = 1.45, 95% CI: 1.05, 2.00); children with allergic gastrointestinal symptoms slept 0.28 h less during nighttime (95% CI: −0.48, −0.07) and 0.25 h less per day (95% CI: −0.43, −0.08), and had 59% higher odds of irregular sleep (95% CI: 1.24, 2.04). We also found significant association of multiple allergic symptoms with shortened nighttime sleep duration and increased irregular sleep. Whereas, allergic skin, mouth and lips, and wheeze symptoms were not significantly associated with sleep outcomes.Conclusion: Allergic symptoms within 2 years of age were adversely associated with sleep outcomes, which highlight the importance of early screening of allergic symptoms in toddlers in order to improve their sleep outcomes.

Highlights

  • Sleep plays a critical role in promoting child health and development [1]

  • We found that the associations between allergic symptoms and poor sleep outcomes were stronger in 2-year-old toddlers with several allergic symptoms that appeared in nose, eyes and digestive system

  • We found that toddlers with multiple allergic symptoms had shorter nighttime sleep duration and higher risk of parent-reported irregular sleep

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Summary

Introduction

Sleep plays a critical role in promoting child health and development [1]. Short sleep duration and apparent epidemic of sleep disturbances (e.g., 20–35% for difficult falling or maintaining sleep) among infants and toddlers have posed a great health concern worldwide [2, 3]. Behavioral and social factors that potentially impact sleep [6], current studies have linked sleep outcomes to allergic diseases and related symptoms in toddlers, which has been increasingly prevalent worldwide. In Chinese cities, 41% of infants and toddlers have ever experienced one or more allergic symptoms [10]. These bothersome allergic symptoms tend to deteriorate at night and may interfere with sleep process through pathophysiologic mechanisms of fluctuations in inflammatory mediators, melatonin and cortisol dysregulation, and a broader autonomic dysfunction [11,12,13]. This study aimed to investigate the associations between multiple allergic symptoms and sleep outcomes in early life

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