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Published online January 18, 2010
PEDIATRICS Vol. 125 No. 2 February 2010, pp. e261-e268 (doi:10.1542/peds.2009-0690)
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ARTICLES

Associations Between Secondhand Smoke Exposure and Sleep Patterns in Children

Kimberly Yolton, PhDa, Yingying Xu, MS, MAa, Jane Khoury, PhDb, Paul Succop, PhDc, Bruce Lanphear, MD, MPHd, Dean W. Beebe, PhDe, Judith Owens, MDf

Divisions of a General and Community Pediatrics and
b Biostatistics and Epidemiology, and
e Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
c Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio;
d Faculty of Health Sciences, Simon Frasier University and British Columbia Children's Hospital, Vancouver, Canada; and
f Department of Pediatrics, Brown University, Providence, Rhode Island

OBJECTIVES The objective of this study was to investigate the relationship between exposure to secondhand smoke (SHS) and child sleep patterns among a group of children with asthma who were exposed regularly to tobacco smoke at home.

METHODS We studied 219 children who were enrolled in an asthma intervention trial and were exposed regularly to SHS. Serum cotinine levels were used to measure exposure to tobacco smoke, and sleep patterns were assessed through parent reports using the Children's Sleep Habits Questionnaire. Covariates in adjusted analyses included gender, age, race, maternal marital status, education, and income, prenatal tobacco exposure, maternal depression, Home Observation for Measurement of the Environment total score, household density, asthma severity, and use of asthma medications.

RESULTS Exposure to SHS was associated with sleep problems, including longer sleep-onset delay (P = .004), sleep-disordered breathing (P = .02), parasomnias (P = .002), daytime sleepiness (P = .022), and overall sleep disturbance (P = .0002).

CONCLUSIONS We conclude that exposure to SHS is associated with increased sleep problems among children with asthma.

Key Words: passive smoking • environmental exposure • sleep • child • asthma

Abbreviations: CSHQ = Children's Sleep Habits Questionnaire • OR = odds ratio • CI = confidence interval • SHS = secondhand smoke • HOME = Home Observation for Measurement of the Environment

Accepted Aug 3, 2009.


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