PURPOSE OF THE STUDY.
To examine the association between obesity, sleep-disordered breathing, and asthma severity in children.
The study included 108 asthmatic children, aged 4 to 18 years, 45.4% African American and 67.6% male subjects, enrolled in an asthma specialty clinic at Rainbow Babies and Children’s Hospital, Cleveland, Ohio.
Sleep-disordered breathing was measured by a written questionnaire to assess snoring, as well as by 2 nights of home pulse oximetry. The duration of the study was 1 year, and participants were prospectively followed every 6 months. Data collected at these visits included current asthma and allergy medications, Asthma Control Test score to determine asthma symptom burden, asthma-related missed school days, number of prednisone courses, number of unscheduled physician and emergency department visits, and number of hospitalizations since the previous visit.
Of the 108 children, 29 were diagnosed with severe asthma, and the remaining 79 had mild/moderate asthma. The severe asthmatics were more likely to be male, African American, and of lower socioeconomic status. Sleep-disordered breathing was strongly associated with asthma severity (P < .01). Obesity, as measured by BMI z scores, did not have a significant association with asthma severity (P = .31). However, extreme obesity was more prevalent in severe asthmatics than nonsevere asthmatics (20.7% vs 10.1%, P = .20). Also, increases in BMI strengthened the association between sleep-disordered breathing and severe asthma.
Sleep-disordered breathing correlates with asthma severity. Obesity and asthma severity were not significantly associated.
Previous studies have demonstrated parallels among obesity, sleep-disordered breathing, and asthma (Sulit LG, Storfer-Iseer A, Rosen CL, et al. Am J Respir Crit Care Med. 2005;171:659–664). However, the association of these disorders to asthma severity, particularly in the pediatric population, has not been thoroughly investigated. This study discovered an important association between severe asthma and sleep-disordered breathing. Future studies are required to examine these interactions in a broader population and to determine whether management of sleep-disordered breathing and/or obesity has the potential to ameliorate asthma prevalence and severity in children.
- Copyright © 2012 by the American Academy of Pediatrics