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.

Keywords: Asthma control; Asthma control questionnaire (ACQ); Questionnaire, pediatric sleep questionnaire (PSQ); SRBD scale; Sleep-related breathing disorder (SRBD).