Abstract
BackgroundAdolescence, as a transition between childhood and adulthood, is a critical stage for the long-term control of atopic diseases. We aim to determine if sleep characteristics are involved in the increased risk of atopic disease among adolescents.MethodsAdopting the stratified cluster random sampling method, this cross-sectional survey included 4932 participants aged 12–18 years. The Chinese version of adolescent sleep disturbance questionnaire and the adolescent sleep hygiene scale were used to collect information on sleep problems and sleep hygiene, respectively. Logistic regression models were implemented to examine the associations of sleep with atopic diseases.ResultsSleep duration was not found to be related with allergic diseases. By contrast, sleep-disordered breathing was associated with an increased risk of asthma (adjusted OR = 1.79, 95% CI 1.25–2.55), allergic rhinitis (adjusted OR = 1.95, 95% CI 1.52–2.49), and eczema (adjusted OR = 1.63, 95% CI 1.23–2.16); poor sleep physiology was correspondent to increased odds of asthma (adjusted OR = 1.69, 95% CI 1.24–2.29), allergic rhinitis (adjusted OR = 1.40, 95% CI 1.13–1.73) and eczema (adjusted OR = 1.66, 95% CI 1.32–2.09); non-optimal sleep environment was associated with an increased prevalence of asthma (adjusted OR = 1.52, 95% CI 1.08–2.12), allergic rhinitis (adjusted OR = 1.32, 95% CI 1.04–1.69) and eczema (adjusted OR = 1.53, 95% CI 1.19–1.96).ConclusionsAs sleep-disordered breathing, poor sleep physiology and non-optimal sleep environment were associated with a higher risk of allergic diseases, the results of this study provide a new concept for the adjuvant treatment of allergic diseases in adolescents. Management strategies of allergic diseases should take regular screening and targeted treatment of sleep issues into account.
Highlights
Adolescence, as a transition between childhood and adulthood, is a critical stage for the longterm control of atopic diseases
Difficulty in maintaining sleep (p = 0.002, p* = 0.008), sleep-disordered breathing (p < 0.001, p* < 0.001), poor sleep physiology (p = 0.001, p* = 0.008) and sleep emotion (p = 0.002, p* = 0.008) were all associated with an increased risk of allergic rhinitis, even after adjusting for multiple comparisons
When it comes to sleep duration, only sleep < 8 h on weekend was associated with an increased risk of eczema (p = 0.03, p* = 0.04)
Summary
Adolescence, as a transition between childhood and adulthood, is a critical stage for the longterm control of atopic diseases. Longitudinal studies further suggest that sleep problems, e.g., being overtired, sleep-disordered breathing, and persistent frequent nocturnal waking, were associated with higher risks of allergic rhinitis or asthma in western adolescents, it does not result in higher odds of eczema [16]. A prospective observational study conducted in Ohio, USA suggested that sleep-disordered breathing can be a modifiable risk factor for severe asthma, revealing that asthma symptoms could be improved by treating SDB [17]. These findings indicated a potential link between sleep and allergic diseases, evidence on adolescence is still scarce. Sleep patterns on weekdays and weekends were analyzed separately as different school schedules and socioeconomic factors may lead to divergent sleep characteristics among Chinese adolescents and those in Western countries [18]
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