scholarly journals Relationship between Poorly Controlled Asthma and Sleep-Related Breathing Disorders in Children with Asthma: A Two-Center Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yun Guo ◽  
Xiuqing Zhang ◽  
Feng Liu ◽  
Ling Li ◽  
Deyu Zhao ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Respiratory Diseases ◽  
Multiple Logistic Regression Analysis ◽  
Sleep Related Breathing Disorders ◽  
Chronic Respiratory Diseases ◽  
Asthmatic Children ◽  
Breathing Disorders ◽  
Children With Asthma ◽  
The Relationship

Objective. Asthma and sleep-related breathing disorders (SRBD) are common chronic respiratory diseases in children. The relationship between asthma and SRDB is bidirectional. However, only a few studies have analyzed the relationship between asthma control status and risk of SRBD. The aim of this study was to evaluate the relationship between asthma control and SRBD and further assess the relationship between therapy/atopy/lung function of children with asthma and SRBD. Methods. A total of 209 children aged 3–16 years were enrolled in this study. Pediatric sleep questionnaire (PSQ) scores were used to identify children at high risk of developing SRBD. Data on asthma control status, therapy, allergy, lung function, and exhaled nitric oxide were collected. Results. A significantly higher risk of SRBD was found among children with poorly controlled asthma (34.25% vs. 13.97%, P  < 0.01) and allergic rhinitis (AR) (34.29% vs. 13.92%, P  < 0.01) than among children with well-controlled asthma and AR. The prevalence of SRBD was also significantly higher in asthmatic children with obesity than that with just obesity (42.11% vs. 20.00%, P  < 0.05). Multiple logistic regression analysis showed that poorly controlled asthma (OR, 2.746 (95% CI, 1.215–6.209); P  < 0.05) and poorly controlled AR (OR, 3.284 (95% CI, 1.430–7.544); P  < 0.01) increased the odds of having SRBD. Conclusion. Poorly controlled asthma and AR increase the risk of SRBD. A routine check of the level of asthma control and appropriate use of medication for AR are important because of their influence on SRBD.

scholarly journals Overlap of Sleep Disorders and Chronic Respiratory Diseases: An Emerging Health Dilemma

2019 ◽  
Vol 2 (2) ◽  
pp. 243-249
Author(s):  
Puru Koirala ◽  
Narendra Bhatta ◽  
Ram Hari Ghimire ◽  
Deebya Raj Mishra ◽  
Bidesh Bista ◽  
...  
Keyword(s):  
Developing Countries ◽  
Respiratory Symptom ◽  
Respiratory Diseases ◽  
Overlap Syndrome ◽  
P Value ◽  
Sleep Related Breathing Disorders ◽  
Chronic Respiratory Diseases ◽  
Breathing Disorders ◽  
Symptom Complex ◽  
Sleep Related Breathing Disorder

Introduction: The burden of Overlap Syndrome (coexistence of sleep-related breathing disorders in patients with respiratory diseases) is high in developing countries, and such a phenomenon implies higher morbidity. The study was conducted to measure the prevalence of sleep-related breathing disorders in patients with Respiratory Symptom Complex and to identify factors associated with the severity of sleep-related breathing disorders.Materials and Methods: A hospital-based cross-sectional study of 50 patients with respiratory symptom complex was conducted at BP Koirala Institute of Health Sciences. Structured proforma and Polysomnography were used for analysis.Results: There were 24 patients (48%) with COPD, 18 (36%) with Bronchial Asthma. 6 patients (12%) with Bronchiectasis and 2 patients with Interstitial Lung Disease. 60% (n=30) patients had sleep-related breathing disorder or Overlap syndrome, 14 patients (46.67%) had mild sleep-related breathing disorder while 16 (53.33%) patients had moderate to severe type. 62.5% COPD patients, 55.55% Bronchial Asthma patients, 50% of patients with Interstitial Lung Disease and 50% Post-TB Bronchiectasis patients had a sleep-related breathing disorder. There was a significant positive correlation between the presence of sleep-related breathing disorder in patients with respiratory symptom complex and high neck circumference (0.499, p-value <0.001), waist circumference (0.293, p-value = 0.039) and hip circumference (0.371, p-value = 0.008).Conclusions: Overlap Disorders comprising sleep disorders in patients with chronic respiratory diseases are high in developing countries. Routine sleep history and polysomnography in all patients with Respiratory Symptom Complex can detect sleep-related breathing disorders.

scholarly journals Assessment of asthma control and lung function in asthmatic children in Sokoto, North Western Nigeria

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Fatima Abubakar Ishaq ◽  
Bilkisu Ilah Garba ◽  
Nma Mohammad Jiya ◽  
Ahmed Hamidu
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Global Initiative ◽  
Gina Guidelines ◽  
Study Participants

Objectives: This study aimed at assessing asthma control using Global Initiative for Asthma (GINA) asthma assessment, and determining its relationship with lung function parameters among asthmatic children in Usmanu Danfodiyo University Teaching hospital, Sokoto. Materials and Methods: This was a cross-sectional study among 60 children with asthma diagnosed based on GINA guidelines. It was conducted over a period of 4 months. The GINA asthma control assessment was administered to assess asthma control. Lung function was done using a portable spirometer. Results: Males accounted for 58.3% of the study population with M: F of 1.4:1 and median age of 9.47 years, with majority from urban domicile (91.7%). Well-controlled asthma accounted for 50.0% while 35.0% had partly controlled asthma and 15.0% had poorly controlled asthma. The median FEV1/FVC among the study participants was 0.856 (IQR: 0.170). There was no relationship between asthma control and LF parameters (FEV1: r = 0.044, P = 0.736, FVC: r = 0.010, P = 0.941, FEV1/FVC: r = 0.122, P = 0.352, and PEFR: r = 0.015, P = 0.911). Conclusion: Majority of the study participants had well-controlled asthma and no relationship was found between asthma control and lung function. Thus, serial monitoring of LF in addition to uniformly agreed standardized assessment of asthma control is required to objectively evaluate asthma control in children.

scholarly journals Respiratory function declines in children with asthma associated with chemical species of fine particulate matter (PM2.5) in Nagasaki, Japan

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yoonhee Kim ◽  
Eun Ha Park ◽  
Chris Fook Sheng Ng ◽  
Yeonseung Chung ◽  
Kunio Hashimoto ◽  
...  
Keyword(s):  
Air Pollution ◽  
Lung Function ◽  
Urban Areas ◽  
Chemical Species ◽  
Mixed Effects ◽  
Linear Mixed Effects Model ◽  
Linear Mixed Effects ◽  
Asthmatic Children ◽  
Transboundary Air Pollution ◽  
Children With Asthma

Abstract Background The differential effects of PM2.5 fractions on children’s lung function remain inconclusive. This study aimed to examine whether lung function in asthmatic children was associated with increased PM2.5 fractions in urban areas in Nagasaki prefecture, Japan, where the air pollution level is relatively low but influenced by transboundary air pollution. Methods We conducted a multiyear panel study of 73 asthmatic children (boys, 60.3%; mean age, 8.2 years) spanning spring 2014–2016 in two cities. We collected self-measured peak expiratory flow (PEF) twice a day and daily time-series data for PM2.5 total mass and its chemical species. We fitted a linear mixed effects model to examine short-term associations between PEF and PM2.5, adjusting for individual and time-varying confounders. A generalized linear mixed effects model was also used to estimate the association for worsening asthma defined by severe PEF decline. Back-trajectory and cluster analyses were used to investigate the long-range transboundary PM2.5 in the study areas. Results We found that morning PEFs were adversely associated with higher levels of sulfate (− 1.61 L/min; 95% CI: − 3.07, − 0.15) in Nagasaki city and organic carbon (OC) (− 1.02 L/min; 95% CI: − 1.94, − 0.09) in Isahaya city, per interquartile range (IQR) increase at lag1. In addition, we observed consistent findings for worsening asthma, with higher odds of severe PEF decline in the morning for sulfate (odds ratio (OR) = 2.31; 95% CI: 1.12, 4.77) and ammonium (OR = 1.73; 95% CI: 1.06, 2.84) in Nagasaki city and OC (OR = 1.51; 95% CI: 1.06, 2.15) in Isahaya city, per IQR increase at lag1. The significant chemical species were higher on days that could be largely attributed to the path of Northeast China origin (for sulfate and ammonium) or both the same path and local sources (for OC) than by other clusters. Conclusions This study provides evidence of the differential effects of PM2.5 fractions on lung function among asthmatic children in urban areas, where the Japanese national standards of air quality have been nearly met. Continuous efforts to promote mitigation actions and public awareness of hazardous transboundary air pollution are needed to protect susceptible children with asthma.

THE RELATIONSHIP BETWEEN PARENTAL AND CHILDREN'S SERUM IMMUNOGLOBULIN E (IgE) AND ASTHMA

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 329-329
Author(s):  
Stanley P. Galant
Keyword(s):  
Bronchial Asthma ◽  
Immunoglobulin E ◽  
Skin Tests ◽  
Z Score ◽  
Significant Determinant ◽  
Positive Skin ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Z Scores ◽  
The Relationship

Purpose of the Study. To examine parental factors that influence bronchial asthma and immunoglobulin E (IgE) levels in their children. Methods. The data in this study were derived from the Tucson Epidemiological Study of Airways Obstructive Diseases since 1972. Eleven evaluation periods have been performed since that time. Asthma histories were established by questionnaire. IgE levels were obtained in 738 children, 1043 fathers, and 1261 mothers. IgE levels were determined by paper radioimmunosorbent (PRIST) technique. IgE Z scores were established. An IgE Z score is the number of standard deviations IgE differs from matched age and sex-matched subjects and log corrected. Skin tests were performed by prick technique to house dust, mold, grass, tree and weed mix and appropriate controls. Results. The percentage of children with bronchial asthma increased with the presence of asthma in parents so that 11.5% of children with asthma occurred in families with no parental asthma compared with 48.6% when both parents had asthma. The rate of childhood bronchial asthma was significantly related to parental IgE levels only when the mother and father had bronchial asthma (43% vs 20%) and much less so (22% vs 10%), when there was no parental asthma. In addition, asthma in the child proved to be a highly significant determinant of the child's IgE Z score, even after correcting for parental IgE Z score. The presence of atopy (ie, positive skin tests) was also not a significant determinant of IgE levels in asthmatic children. Discussion. The authors conclude that the inheritance of IgE is only one factor related to the development of asthma, and is limited as a predictor.

scholarly journals EVALUATION OF INDUCED SPUTUM CYTOLOGY IN ASTHMATIC CHILDREN

2021 ◽  
Author(s):  
Debora Carla Chong-Silva ◽  
Adriana Nascimento ◽  
Roberta Cunha ◽  
Elessandra Bitencourt ◽  
Leticia Botelho ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Pulmonary Function Tests ◽  
Sputum Cytology ◽  
Asthma Control Test ◽  
Sputum Induction ◽  
Hypertonic Saline Solution ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Children With Asthma

Objective: To evaluate the viability of sputum cytology in asthmatic children, recognizing inflammatory patterns and correlating them with clinical, epidemiological and functional variables of the disease. Methods: This was a cross-sectional and observational study of children with asthma who underwent sputum induction through increasing concentrations of nebulized hypertonic saline solution from 3% to 7%. The samples were processed according to the technique developed by Pizzichini et al. and the cytological pattern classified as pauci-granulocytic, neutrophilic, eosinophilic and mixed. Samples with cell viability> 50% were considered adequate. Asthma control was assessed using the asthma control test (ACT). Results: Seventy-nine children performed sputum induction. Thirty-three samples were excluded because they were not viable for analysis, resulting in 46 samples. The children’s average age was 9.4 (± 3) years. There was a predominance of eosinophilic (25/46, 54.3%), followed by mixed (13/46, 28.3%), pauci-granulocytic (7/46, 15.2%) and neutrophilic (1/46, 2.2%) pattern. Sixty-three percent of the children had severe asthma and 84.7% were treated with inhaled corticosteroids. The ACT showed that 25 (56.8%) patients had the disease under control. Forty-five children (97.8%) underwent pulmonary function tests (spirometry) and in 13 cases (28.9%) an obstructive ventilatory defect was found. Conclusions: The eosinophilic profile was predominant in the assessed asthmatic children. Non-eosinophilic phenotypes were found, but less frequently. There was no difference between the clinical variables and the sputum profile in this study group. Sputum induction in children with asthma is feasible and safe and can contribute to a specific and personalized approach to the disease.

scholarly journals WEARCON: Wearable home monitoring in children with asthma reveals a strong association with hospital based assessment of asthma control.

2020 ◽  
Author(s):  
Mattienne R van der Kamp ◽  
Emilie C Klaver ◽  
Bernard J Thio ◽  
Jean MM Driessen ◽  
Franciscus HC de Jongh ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Asthma Control ◽  
Strong Association ◽  
Multiple Logistic Regression Analysis ◽  
Home Monitoring ◽  
Physiological Parameters ◽  
Respiratory Physiology ◽  
Healthy Children ◽  
Home Setting ◽  
Asthmatic Children

Abstract Asthma is one of the most common chronic diseases in childhood. Regular follow-up of physiological parameters in the home setting, in relation to asthma symptoms, can provide complementary quantitative insights into the dynamics of the asthma status. Despite considerable interest in asthma home-monitoring in children, there is a paucity of scientific evidence, especially on multi-parameter monitoring approaches. Therefore, the aim of this study is to investigate whether asthma control can be correctly assessed in the home situation by combining parameters from respiratory physiology sensors. Sixty asthmatic and 30 healthy children were enrolled in the observational WEARCON-study. The paediatrician assessed asthma control according to GINA guidelines. All children were also evaluated during a 2-week home-monitoring period with wearable devices; a physical activity tracker, a handheld spirometer, smart inhalers, and an ambulatory electrocardiography device to monitor heart and respiratory rate. Multiple logistic regression analysis was used to determine which diagnostic measures were associated asthma control. All 27 of the 27 uncontrolled asthmatic children and 31 of the 32 controlled asthmatic children could correctly be identified with this model. The final model showed that a larger variation in pre-exercise lung function (OR=1.36 95%-CI 1.06-1.75), an earlier wake-up-time (OR=1.06 95%-CI 1.01-1.11), more reliever use (OR=1.14 95%-CI 1.05-1.24) and a longer respiratory rate recovery time (OR=1.18 95%-CI 1.04-1.34) were significant contributors to the probability of having uncontrolled asthma. Home-monitoring of physiological parameters is associated with paediatrician assessed asthma control. The constructed multivariate model identifies 100% of all uncontrolled asthmatic children, indicating a high potential for monitoring of asthma control. This may allow healthcare professionals to assess asthma control at home. Trial registration: Netherlands Trail Register, NL6087. Registered 14 February 2017, https://www.trialregister.nl/trial/6087

Abstract 17063: Sleep Related Breathing Disorders and Heart Rate Variability in Young and Healthy Adults From the General Population

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Stefanie Aeschbacher ◽  
Matthias Bossard ◽  
Mirco von Rotz ◽  
Tobias Schoen ◽  
Anna Maseli ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sleep Apnea ◽  
Large Population ◽  
Healthy Adults ◽  
Apnea Hypopnea Index ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Relationship Of ◽  
The Relationship

Background: The influence of sleep related breathing disorders on heart rate variability (HRV), a measure of autonomic nervous function, is not well studied. We therefore assessed the relationship of the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI) with 24-hour HRV in a large population of young and healthy adults. Methods: Individuals aged between 25-41 years with a body mass index ≤35km/kg2 and without known sleep apnea syndrome (SAS) or cardiovascular disease were included in the population-based GAPP-study. A 24-hour electrocardiogram (ECG) was obtained in every participant, and systematic post-processing performed with a dedicated software. The standard deviation of all normal RR intervals (SDNN) was used as main HRV marker. AHI and ODI were obtained from nighttime pulsoxymetry with nasal airflow measurements. Sleep apnea (SA) was defined as either an AHI ≥5 or an ODI ≥5. Multivariable regression models were constructed to assess the relationship of SDNN with either AHI or ODI and to adjust for a large number of confounders. Results: We included 1266 participants (47% men) with a median age of 35 years. Mean SDNN among men and women was 162 and 148ms (p<0.0001), respectively. The proportion of participants with SA using an AHI- or ODI-based definition was 10 and 11%, respectively. Compared to individuals without SA, the beta coefficient (95% confidence interval (CI)) for SDNN was -7.48 (-14.75; -0.23, p=0.04) among those with an AHI-based SA definition, and was -11.45 (-18.39; -4.52, p=0.001) among those with an ODI-based SA definition. A highly significant inverse trend across different categories of AHI and ODI was observed, as shown in the Table. Conclusion: Early stages of sleep related breathing disorders are strongly associated with decreasing HRV in young and healthy adults, without evidence of a threshold. These findings suggest a tight link between sleep related breathing disorders and autonomic dysfunction.

scholarly journals Characterising a Weight Loss Intervention in Obese Asthmatic Children

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 507
Author(s):  
Shaun Eslick ◽  
Megan E. Jensen ◽  
Clare E. Collins ◽  
Peter G. Gibson ◽  
Jodi Hilton ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Lung Function ◽  
Clinical Outcomes ◽  
Asthma Control ◽  
Diet Quality ◽  
Activity Level ◽  
Weight Loss Intervention ◽  
Z Score ◽  
Asthmatic Children

The prevalence of obesity in asthmatic children is high and is associated with worse clinical outcomes. We have previously reported that weight loss leads to improvements in lung function and asthma control in obese asthmatic children. The objectives of this secondary analysis were to examine: (1) changes in diet quality and (2) associations between the baseline subject characteristics and the degree of weight loss following the intervention. Twenty-eight obese asthmatic children, aged 8–17 years, completed a 10-week diet-induced weight loss intervention. Dietary intake, nutritional biomarkers, anthropometry, lung function, asthma control, and clinical outcomes were analysed before and after the intervention. Following the intervention, the body mass index (BMI) z-score decreased (Δ = 0.18 ± 0.04; p < 0.001), %energy from protein increased (Δ = 4.3 ± 0.9%; p = 0.002), and sugar intake decreased (Δ = 23.2 ± 9.3 g; p= 0.025). Baseline lung function and physical activity level were inversely associated with Δ% fat mass. The ΔBMI z-score was negatively associated with physical activity duration at baseline. Dietary intervention is effective in achieving acute weight loss in obese asthmatic children, with significant improvements in diet quality and body composition. Lower lung function and physical engagement at baseline were associated with lesser weight loss, highlighting that subjects with these attributes may require greater support to achieve weight loss goals.

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