Sleep-disordered Breathing and Asthma Severity

Abstract

Research Article| April 01 2012 Sleep-disordered Breathing and Asthma Severity AAP Grand Rounds (2012) 27 (4): 39. https://doi.org/10.1542/gr.27-4-39 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Sleep-disordered Breathing and Asthma Severity. AAP Grand Rounds April 2012; 27 (4): 39. https://doi.org/10.1542/gr.27-4-39 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: asthma, sleep apnea syndromes, obesity Source: Ross KR, Storfer-Isser A, Hart MA, et al. Sleep-disordered breathing is associated with asthma severity in children. J Pediatr. In press; doi: https://doi.org/10.1016/j.jpeds.2011.10.008 Researchers from Case Western Reserve University, Cincinnati Children’s Hospital Medical Center, and Harvard Medical School conducted a prospective observational study of children diagnosed with asthma to assess the relationship of their asthma severity with obesity and sleep-disordered breathing (SDB). Patients diagnosed with asthma by a pediatric pulmonologist were eligible for the project and were recruited sequentially from the asthma clinic at a tertiary medical center and followed for one year. At the one-year follow-up each child was classified as having either severe or mild/moderate asthma. Severe asthma was defined based on required clinical treatment (≥2 hospitalizations, ≥3 treatments with systemic corticosteroids, or ≥3 unscheduled doctor or emergency department visits); diagnostic testing (asthma control test [ACT] score ≤14); or pharmacologic therapy (regular use of high-dose inhaled corticosteroids or every-other-day/daily systemic corticosteroids). Based on body mass index (BMI) at baseline, the children were categorized as normal (BMI <85th percentile), overweight (BMI ≥85th and <95th percentile), obese (BMI ≥95th percentile and <99th percentile), or extremely obese (BMI ≥99th percentile). Sixty (55.6%) of the children were obese or extremely obese. SDB was defined as parent-reported snoring “louder than talking” three or more times per week and an average of three or more desaturations per hour of at least 3% during two nights of oximetry monitoring. A total of 108 children were enrolled in the study. Mean age was 9.1±3.4 years (range 4–18 years), 67.6% (73/108) were male, and 45.4% (49/108) were African American. Thirty-two children (29.6%) had SDB. At the one-year follow-up, 29 children (26.9%) were categorized as having severe asthma and the remaining 79 children (73.1%) as having mild/moderate asthma. Children with severe asthma were more likely to be African American and come from lower income households. BMI z-scores were not associated with asthma severity at follow-up and there was no significant difference in the prevalence of extreme obesity between children with severe and mild/moderate asthma. SDB was more likely among children with severe asthma (55.2% vs 20.3%; P<.01; OR=4.85). Even after adjusting for obesity, gender, and race, children with SDB had 3.62-fold greater odds of having severe asthma (P=.02). The authors conclude that among asthmatics who had received a year of management by a pediatric pulmonologist, SDB is a risk factor for having severe asthma. Dr Dubik has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. A 2005 study by some of the same authors of this article found an increased prevalence of asthma in obese children and the possibility that some of this relationship may be explained by SDB.1 In the current study, these children were re-evaluated after 12 months of follow-up. Perhaps somewhat surprisingly in this study, while obesity was not associated with the severity... You do not currently have access to this content.