Sleep and Breathing

, Volume 17, Issue 1, pp 281–287 | Cite as

Increased sleep latency and reduced sleep duration in children with asthma

  • Megan E. Jensen
  • Peter G. Gibson
  • Clare E. Collins
  • Jodi M. Hilton
  • Fiona Latham-Smith
  • Lisa G. Wood
Original Article

Abstract

Study objective

Sleep disturbance is reported to be more prevalent in children and adolescents with asthma than those without. However, this has not been described adequately using objective measures. The aim of this study was to objectively characterise sleep disturbance in asthmatic and non-asthmatic children and adolescents.

Methods

A retrospective analysis of polysomnography recordings from children aged 5–17 years old, with (n = 113) and without asthma (n = 104), referred for a sleep study over the period 2005–2010 at the Paediatric Sleep Unit, John Hunter Children’s Hospital in Newcastle, NSW Australia, was carried out.

Results

Polysomnographic recordings were analysed to compare sleep quality and quantity between asthmatic and non-asthmatic children. Sleep latency was significantly longer in asthmatic children compared to controls. However, this result was significant for females only (46.2 (5.6) vs 33.2 (2.7) min, p < 0.05). Male asthmatics had significantly shorter sleep duration (425.9 (5.4) vs 441.8 (5.4) min, p < 0.05) than male controls.

Conclusions

Sleep disturbance exists in children with asthma and manifests differently in males and females. Further investigation into the clinical implication of increased sleep latency and reduced sleep duration upon daytime functioning and lifestyle behaviours in children and adolescents with asthma is warranted.

Keywords

Adolescent Asthma Child Polysomnography Sleep 

Abbreviations

AI

Arousal index

BMI

Body mass index

CVD

Cardiovascular disease

ECG

Electrocardiogram

EEG

Electroencephalogram

EMG

Electromyogram

FEV1

Forced expiratory volume in one second

FVC

Forced vital capacity

IQR

Interquartile range

PSG

Polysomnography

PEF

Pulmonary expiratory flow

PSU

Paediatric sleep unit

RDI

Respiratory disturbance index

REM

Rapid eye movement

SEM

Standard error mean

TST

Total sleep time

TTA

Total time awake

OSA

Obstructive sleep apnea

References

  1. 1.
    Masoli M, Fabian D, Holt S, Beasley R (2004) Global burden of asthma: a report prepared for the global initiative for asthma. GINA: 1-12Google Scholar
  2. 2.
    Australian Centre for Asthma Monitoring (2009) Asthma in Australian children: findings from Growing Up in Australia, the longitudinal study of Australian children. Australian Institute of Health and Welfare, CanberraGoogle Scholar
  3. 3.
    Australian Centre for Asthma Monitoring (2008) Asthma in Australia. In: AIHW asthma series no. 3. Australian Institute of Health and Welfare, Canberra.Google Scholar
  4. 4.
    Sadeh A, Horowitz I, Wolach-Benodis L, Wolach B (1998) Sleep and pulmonary function in children with well-controlled, stable asthma. Sleep 21(4):379–384PubMedGoogle Scholar
  5. 5.
    Strunk RC, Sternberg AL, Bacharier LB, Szefler SJ (2002) Nocturnal awakening caused by asthma in children with mild-to-moderate asthma in the childhood asthma management program. J Allergy Clin Immunol 110(3):395–403PubMedCrossRefGoogle Scholar
  6. 6.
    Stores G, Ellis A, Wiggs L, Crawford C, Thomson A (1998) Sleep and psychological disturbance in nocturnal asthma. Arch Dis Child 78(5):413–419PubMedCrossRefGoogle Scholar
  7. 7.
    Luyster F, Teodorescu M, Bleecker E, Busse W, Calhoun W, Castro M, Chung K, Erzurum S, Israel E, Strollo P, Wenzel S (2011) Sleep quality and asthma control and quality of life in non-severe and severe asthma. Sleep Breath. doi:10.1007/s11325-011-0616-8
  8. 8.
    Chugh IM, Khanna P, Shah A (2006) Nocturnal symptoms and sleep disturbances in clinically stable asthmatic children. Asian Pac J Allergy Immunol 24(2):135–142PubMedGoogle Scholar
  9. 9.
    Paavonen JE, Raikkonen K, Pesonen A-K, Lahti J, Komsi N, Heinonen K, Jarvenpaa A-L, Strandberg T, Kajantie E, Porkka-Heiskanen T (2010) Sleep quality and cognitive performance in 8-year-old children. Sleep Med 11:386–392PubMedCrossRefGoogle Scholar
  10. 10.
    Anderson B, Storfer-Isser A, Taylor HG, Rosen CL, Redline S, Anderson B, Storfer-Isser A, Taylor HG, Rosen CL, Redline S (2009) Associations of executive function with sleepiness and sleep duration in adolescents. Pediatrics 123(4):e701–e707PubMedCrossRefGoogle Scholar
  11. 11.
    Spruyt K, Molfese DL, Gozal D (2011) Sleep duration, sleep regularity, body weight, and metabolic homeostasis in school-aged children. Pediatrics. doi:10.1542/peds.2010-0497
  12. 12.
    Chen X, Beydoun MA, Wang Y (2008) Is sleep duration associated with childhood obesity? A systematic review and meta-analysis. Obesity 16:265–274PubMedCrossRefGoogle Scholar
  13. 13.
    Bayer O, Neuhauser H, von Kries R, Bayer O, Neuhauser H, von Kries R (2009) Sleep duration and blood pressure in children: a cross-sectional study. J Hypertens 27(9):1789–1793PubMedCrossRefGoogle Scholar
  14. 14.
    Gangwisch JE, Malaspina D, Babiss LA, Opler MG, Posner K, Shen S, Turner JB, Zammit GK, Ginsberg HN, Gangwisch JE, Malaspina D, Babiss LA, Opler MG, Posner K, Shen S, Turner JB, Zammit GK, Ginsberg HN (2010) Short sleep duration as a risk factor for hypercholesterolemia: analyses of the National Longitudinal Study of Adolescent Health. Sleep 33(7):956–961PubMedGoogle Scholar
  15. 15.
    Wells JC, Hallal PC, Reichert FF, Menezes AM, Araujo CL, Victora CG, Wells JCK, Menezes AMB, Araujo CLP (2008) Sleep patterns and television viewing in relation to obesity and blood pressure: evidence from an adolescent Brazilian birth cohort. Int J Obes 32(7):1042–1049CrossRefGoogle Scholar
  16. 16.
    Kieckhefer GM, Ward TM, Tsai S-Y, Lentz MJ (2008) Nighttime sleep and daytime nap patterns in school age children with and without asthma. J Dev Behav Pediatr 29(5):338–344PubMedCrossRefGoogle Scholar
  17. 17.
    Hanson MD, Chen E (2008) The temporal relationships between sleep, cortisol, and lung functioning in youth with asthma. J Pediatr Psychol 33(3):312–316PubMedCrossRefGoogle Scholar
  18. 18.
    Tirosh E, Scher A, Sadeh A, Jaffe M, Lavie P (1993) Sleep characteristics of asthmatics in the first four years of life: a comparative study. Arch Dis Child 68(4):481–483PubMedCrossRefGoogle Scholar
  19. 19.
    Kales A, Kales JD, Sly RM, Scharf MB, Tan T-L, Preston TA (1970) Sleep patterns of asthmatic children: all-night electroencephalographic studies. J Allergy 46(5):300–308PubMedCrossRefGoogle Scholar
  20. 20.
    Ramagopal M, Scharf SM, Roberts DW, Blaisdell CJ (2008) Obstructive sleep apnea and history of asthma in snoring children. Sleep Breath 12:381–392PubMedCrossRefGoogle Scholar
  21. 21.
    Rechtschaffen A, and Kales A. (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. US Dept. of Health, Education, and Welfare, Public Health Services—National Institutes of Health, National Institute of Neurological Diseases and Blindness, Neurological Information Network, Los Angeles.Google Scholar
  22. 22.
    Loughlin G, Broullette R et al (1996) American Thoracic Society: standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 153:866–878Google Scholar
  23. 23.
    Thoracic Society of Australia and New Zealand (1994) Guidelines for respiratory sleep studies. TSANZ, AustraliaGoogle Scholar
  24. 24.
    Padez C, Mourao I, Moreira P, Rosado V (2009) Long sleep duration and childhood overweight/obesity and body fat. Am J Hum Biol 21(3):371–376PubMedCrossRefGoogle Scholar
  25. 25.
    Patel SR, Hu FB (2008) Short sleep duration and weight gain: a systematic review. Obesity 16(3):643–653PubMedCrossRefGoogle Scholar
  26. 26.
    Hitze B, Bosy-Westphal A, Bielfeldt F, Settler U, Plachta-Danielzik S, Pfeuffer M, Schrezenmeir J, Monig H, Muller MJ (2009) Determinants and impact of sleep duration in children and adolescents: data of the Kiel Obesity Prevention Study. Eur J Clin Nutr 63(6):739–746PubMedCrossRefGoogle Scholar
  27. 27.
    Westerlund L, Ray C, Roos E (2009) Associations between sleeping habits and food consumption patterns among 10–11-year-old children in Finland. Br J Nutr 102(10):1531–1537PubMedCrossRefGoogle Scholar
  28. 28.
    Ng EP, Ng DK, Chan CH (2009) Sleep duration, wake/sleep symptoms, and academic performance in Hong Kong secondary school children. Sleep & Breathing 13(4):357–367CrossRefGoogle Scholar
  29. 29.
    Touchette E, Petit D, Seguin JR, Boivin M, Tremblay RE, Montplaisir JY, Touchette E, Petit D, Seguin JR, Boivin M, Tremblay RE, Montplaisir JY (2007) Associations between sleep duration patterns and behavioral/cognitive functioning at school entry. Sleep 30(9):1213–1219PubMedGoogle Scholar
  30. 30.
    Fitzpatrick M, Engleman H, Whyte K, Deary I, Shapiro C, Douglas N (1991) Morbidity in nocturnal asthma: sleep quality and daytime cognitive performance. Thorax 46:569–573PubMedCrossRefGoogle Scholar
  31. 31.
    Forbes EE, Bertocci MA, Gregory AM, Ryan ND, Axelson DA, Birmaher B, Dahl RE, Forbes EE, Bertocci MA, Gregory AM, Ryan ND, Axelson DA, Birmaher B, Dahl RE (2008) Objective sleep in pediatric anxiety disorders and major depressive disorder. J Am Acad Child Adolesc Psychiatr 47(2):148–155CrossRefGoogle Scholar
  32. 32.
    Nguyen-Rodriguez ST, McClain AD, Spruijt-Metz D, Nguyen-Rodriguez ST, McClain AD, Spruijt-Metz D (2010) Anxiety mediates the relationship between sleep onset latency and emotional eating in minority children. Eat Behav 11(4):297–300PubMedCrossRefGoogle Scholar
  33. 33.
    Nixon GM, Thompson JM, Han DY, Becroft DM, Clark PM, Robinson E, Waldie KE, Wild CJ, Black PN, Mitchell EA, Thompson JMD, Becroft DMO (2009) Falling asleep: the determinants of sleep latency. Arch Dis Child 94(9):686–689PubMedCrossRefGoogle Scholar
  34. 34.
    Malakasioti G, Gourgoulianis K, Chrousos G, Kaditis (2011) Interactions of obstructive sleep-disordered breathing with recurrent wheezing or asthma and their effects on sleep quality. Pediatric Pulmonology 46(11):1047–1054PubMedCrossRefGoogle Scholar
  35. 35.
    Sarıman N, Levent E, Çubuk R, Yurtlu Ş, Benli Aksungar F (2011) Bronchial hyperreactivity and airway wall thickening in obstructive sleep apnea patients. Sleep Breath 15(3):341–350PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Megan E. Jensen
    • 1
    • 2
  • Peter G. Gibson
    • 1
    • 2
  • Clare E. Collins
    • 3
  • Jodi M. Hilton
    • 4
  • Fiona Latham-Smith
    • 5
  • Lisa G. Wood
    • 1
    • 2
  1. 1.Department of Respiratory and Sleep Medicine, Hunter Medical Research InstituteJohn Hunter HospitalNewcastleAustralia
  2. 2.Centre for Asthma and Respiratory DiseasesUniversity of NewcastleNewcastleAustralia
  3. 3.School of Health Sciences, Faculty of HealthUniversity of NewcastleNewcastleAustralia
  4. 4.Paediatric Respiratory and Sleep MedicineJohn Hunter Children’s HospitalNewcastleAustralia
  5. 5.Paediatric Sleep UnitJohn Hunter Children’s HospitalNewcastleAustralia

Personalised recommendations