Association of Asthma and Allergic Rhinitis With Sleep-Disordered Breathing in Childhood.

Paschalis Steiropoulos,Maria Iordanidou,Evangelia Nena,Emmanouil Paraskakis,Athanasios Chatzimichael,Argyrios Tzouvelekis,Evanthia Perikleous

doi:10.3389/fped.2018.00250

Abstract

Objective: Asthma and allergic rhinitis (AR) are the most common chronic conditions in childhood and have previously been linked to sleep-related breathing disorder (SRBD). Aim of the study was to examine the association between SRBD risk and asthma control in children with asthma and with or without AR.Methods: The assessment of FeNO and pulmonary function tests were performed in 140 children (65 with asthma, 57 with both asthma, and AR, 18 with only AR). Children with asthma completed the childhood Asthma Control Test (c-ACT), and the Sleep-Related Breathing Disorder scale, extracted from the Pediatric Sleep Questionnaire (PSQ). C-ACT scores ≤ 19 are indicative of poor asthma control whereas SRBD from PSQ scores ≥ 0.33 are suggestive of high risk for SRBD.Results: Mean age ± SD was 7.8 ± 3.1 years. Mean PSQ ± SD and c-ACT ± SD scores were 0.17 ± 0.14 and 24.9 ± 3.2, respectively. High risk for SRBD was identified in 26 children. Children at high risk for SRBD had significantly decreased c-ACT score (P = 0.048), verified by a negative association between c-ACT and PSQ-SRBD scores (r = −0.356, P < 0.001). Additionally a difference in diagnosis distribution between children at high or low risk for SRBD was observed. More specifically, among children at high risk, 88.5% were diagnosed with both atopic conditions, while this percentage among children at low risk was 29.8%. Asthma was mainly diagnosed in the latter group (P < 0.001).Conclusions: Poor asthma control is associated with SRBD. The presence of AR in children with asthma seems to increase the prevalence of SRBD in that particular population, requiring further investigation toward this direction.

Highlights

Asthma is the most common chronic disease among children and has a significant financial impact in the Western world, especially in European countries [1], asserting that asthma control is of cardinal importance for public health
A recent study showed that sleep-related breathing disorder (SRBD) is a robust risk factor for not-well-controlled asthma; through multivariate logistic regression analysis, the researchers have shown that the coexistence of SRBD and tonsillar hypertrophy were independent risk factors for not-wellcontrolled asthma after adjusting for other established factors to asthma control [9]
In the present study we have demonstrated that poor asthma control is associated with high risk for SRBD in children

Summary

Introduction

Asthma is the most common chronic disease among children and has a significant financial impact in the Western world, especially in European countries [1], asserting that asthma control is of cardinal importance for public health. Management of symptoms and comorbidities are of fundamental importance for disease control [2]. Children with asthma and AR, exhibit poorer asthma control, reduced quality of life, increased risk for emergency visits, or hospitalizations, and higher health care burden [5, 6]. The link among asthma and sleep-related breathing disorder (SRBD) is bidirectional due to common risk contributors that, induce airway inflammation [7, 8]. SRBD in children with asthma may lead to difficult-to-control asthma. A recent study showed that SRBD is a robust risk factor for not-well-controlled asthma; through multivariate logistic regression analysis, the researchers have shown that the coexistence of SRBD and tonsillar hypertrophy were independent risk factors for not-wellcontrolled asthma after adjusting for other established factors to asthma control [9]

Methods

Results

Discussion

Conclusion