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Association of Symptoms of Sleep-Related Breathing Disorders with Asthma Control in Indian Children

Abstract

Objective

To explore the association of symptoms of sleep-related breathing disorders (SRBD) with asthma control in Indian children.

Methods

This study was carried out in the pediatric chest clinic of a tertiary care center in western India. Children from 6 to 18 y of age with a physician-diagnosed case of asthma were included in the study. A validated pediatric sleep questionnaire, SRBD scale, was used to screen the symptoms of SRBD. At the same time, Asthma Control Questionnaire (ACQ) was administered to assess asthma control.

Results

A total of 207 (73% boys) children with asthma were enrolled; the median age was 10 (7, 13) y. Asthma symptoms were well controlled (ACQ ≤ 0.75) in 102 (49.3%) and partly or poorly controlled (ACQ > 0.75) in 105 (50.7%) children. Inattention and/or hyperactivity was the most common SRBD symptom observed in 125 (60.4%) children; daytime sleepiness, mouth breathing, snoring, and night-time breathing problems were observed in 92 (44.5%), 91 (44%), 77 (37.2%), and 68 (32.8%) children, respectively. SRBD score showed a near-linear correlation with ACQ score (r = 0.28, p < 0.001). The score was positive in 52 (25.1%) children. A positive SRBD score was statistically more common in partly or poorly controlled asthma (aOR 2.5; 95% CI: 1.2–5.0; p = 0.01). However, the positive score did not show a statistically significant association with gender, being underweight, obesity, allergic rhinitis, compliance to therapy, and inhalation technique.

Conclusion

SRBD symptoms are common in children with asthma. They showed a statistically significant association with partly or poorly controlled asthma. Therefore, it would be interesting to look for SRBD symptoms in children with partly or poorly controlled asthma.

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Acknowledgments

The authors thank the University of Michigan Regents for permitting the Hindi version of SRBD scales (License No. 10587-umich) and Professor Juniper EF; McMaster University, Canada, for allowing the Hindi version of the Asthma Control Questionnaire (ACQ). They also thank the children and their parents for participating in this study.

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Affiliations

Authors

Contributions

PK conceptualized and designed the study, developed the protocol, took permission to use questionnaires, collected the data, did literature search, analyzed the data, and prepared an initial draft of the manuscript; JPG and KS analyzed the data, did literature review, and prepared the manuscript. All the authors critically revised and approved the final version of the manuscript. PK will act as the guarantor for this study.

Corresponding author

Correspondence to Prawin Kumar.

Ethics declarations

Ethics Committee Approval

The study was approved by the Institute Ethics Committee, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India (AIIMS/IEC/2018/573).

Conflict of Interest

None.

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Cite this article

Kumar, P., Goyal, J.P. & Singh, K. Association of Symptoms of Sleep-Related Breathing Disorders with Asthma Control in Indian Children. Indian J Pediatr (2021). https://doi.org/10.1007/s12098-021-03797-3

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Keywords

  • Asthma control
  • Sleep-related breathing disorder (SRBD)
  • Questionnaire, pediatric sleep questionnaire (PSQ)
  • SRBD scale
  • Asthma control questionnaire (ACQ)