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Polysomnographic characteristics of adolescents with asthma and low risk for sleep-disordered breathing

  • Basheer KhassawnehEmail author
  • Sheila C. Tsai
  • Lisa J. Meltzer
Pediatrics • Original Article
First Online:
  • 22 Downloads

Abstract

Purpose

The aim of this study was to describe the polysomnographic characteristics of adolescents with asthma who are at low risk for sleep-disordered breathing (SDB) based on the Pediatric Sleep Questionnaire (PSQ).

Methods

Overnight polysomnography was performed on 85 adolescents with asthma and a score < 0.33 on the PSQ. The Asthma Control Questionnaire was used to define “well-controlled” versus “inadequately controlled” asthma.

Results

Mean age of participants was 14.5 ± 1.6 years (range, 11 to 17 years), 63.5% were girls, 57.6% were Caucasians, and the mean body mass index percentile was 65.1 ± 26.5. Asthma was well-controlled in 51.7% of the adolescents and inadequately controlled in 15.3%. Mean sleep efficiency (SE) was 88.0 ± 11.1%, and 24.7% had SE < 85%. Mean wakefulness after sleep onset (WASO) was 40.9 ± 44.0 min, and the mean arousal index was 10.8 ± 5.6 per hour. The mean apnea/hypopnea index (AHI) was 2.3 ± 4.2, and 29.4% of participants had SDB (defined by an AHI ≥ 2). Compared with normative values, adolescents with asthma had more nocturnal awakenings and WASO, and less REM sleep. SDB risk was higher in boys [odds ratio = 4.6 (confidence interval 1.4–14.7), p = 0.01]. Asthma control did not impact sleep and respiratory parameters, with no differences found between youth with well-controlled and inadequately controlled asthma.

Conclusions

Adolescents with asthma are at increased risk of sleep-disordered breathing and suffer from disturbances in sleep continuity with more arousals and sleep fragmentation. Study results highlight the importance of proper screening for sleep-disordered breathing in adolescents with asthma.

Keywords

Asthma Sleep Polysomnography Children Adolescence Sleep-disordered breathing 
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Notes

Acknowledgments

B. Khassawneh was on sabbatical leave from the Faculty of Medicine at Jordan University of Science and Technology, Irbid, Jordan. The authors thank the adolescents who participated in this study, the SIESTA team for their assistance with recruitment, as well as Lori Spindler, Emy Basham, and the National Jewish Health Sleep Lab for all of their assistance with data collection.

Funding

This study was funded by the NIH/NHLBI (R01 HL119441).

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the National Jewish Health Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine, Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
  2. 2.Department of MedicineNational Jewish HealthDenverUSA
  3. 3.Department of PediatricsNational Jewish HealthDenverUSA

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