Associations of Sleep Problems with Asthma and Allergic Rhinitis Among Chinese Preschoolers: A Cross-Sectional Study

Background The aim of this study was to examine the associations of sleep problems with asthma and allergic rhinitis among Chinese preschoolers. Methods This cross-sectional survey was conducted in Guangzhou, China. Children aged 3-6 years were selected from 32 kindergartens in 7 regions. Asthma, allergic rhinitis and sleep problem were evaluated by a valid questionnaire. Binary logistic regression models were employed to estimate the odds ratios (OR) and 95% confidence intervals (CI) for asthma and allergic rhinitis according to short sleep duration, late bedtime and frequent nocturnal awaking. Results We included 4876 preschool children. Of these, 182 (3.7%) diagnosed as asthma, and 511 (10.5%) diagnosed as allergic rhinitis. Frequent nocturnal awakening was associated with asthma and allergic rhinitis, adjusted OR were 1.49(95% CI: 1.05~2.13) and 1.59(95%CI: 1.27-1.99), respectively. Further subgroup analysis showed the association of frequent nocturnal awakening with asthma differed by gender. No significant associations of short duration and late bedtime with asthma/ and allergic rhinitis were identified. Conclusions Our data suggested that frequent nocturnal awakening was associated with asthma and allergic rhinitis, and the association of frequent nocturnal awakening with asthma differed by gender. Further studies are warranted to address the causal relationship between nocturnal awaking and asthma and allergic rhinitis.

Associations of Sleep Problems With Asthma/wheeze and Allergic Rhinitis Among Chinese Children Aged 0-6 Years: a Cross-sectional Study

Background: Asthma/wheeze and allergic rhinitis are common among pre-school age children, which urgently need to identify more modifiable risk factors for prevention. The aim of this study was to examine the associations of sleep problems with asthma/wheeze and allergic rhinitis among Chinese children aged 0-6 years. Methods: This cross-sectional survey, a part of the National Survey on Physical Growth and Development of Children in nine cities of China (NSPGDC), was conducted in Guangzhou, China. Children aged 0-6 years were randomly selected from 29 communities and 32 kindergartens. Asthma/wheeze, allergic rhinitis and sleep problem were evaluated by a valid questionnaire which was completed by participants’ parent(s). Binary logistic regression models were employed to estimate the odds ratios (OR) and 95% confidence intervals (CI) for asthma/wheeze and allergic rhinitis according to short sleep duration, late bedtime and frequent nocturnal awaking. Results: We included 13376 children aged 0~6 years. Of these, 371 (2.8%) diagnosed as asthma/wheeze, and 610 (4.6%) diagnosed as allergic rhinitis. Frequent nocturnal awakening was associated with asthma/wheeze and allergic rhinitis, adjusted OR were 1.53 (95% CI: 1.20~1.94) and 1.39(1.14-1.71), respectively. Further subgroup analysis showed the association of frequent nocturnal awakening with asthma/wheeze and allergic rhinitis differed by age. No significant associations of short duration and late bedtime with asthma/wheeze and allergic rhinitis were identified. Conclusions: Our data suggested that frequent nocturnal awakening was associated with asthma/wheeze and allergic rhinitis, but this association differed by age. Further studies are warranted to confirm its’ causal association and to understand the underlying mechanisms.

Factors Associated with Volunteer Activities and Sleep Efficiency in Older Adults with Hypertension: A Sequential Model Study

The purpose of this study was to examine, using a sequential model, factors associated with volunteer participation and sleep efficiency in Japanese older adults receiving treatment for hypertensive disease. A questionnaire survey was conducted to collect data on participant demographics, lifestyle, health status, and depression, and sleep activity monitors were used to objectively measure sleep status and sleep efficacy. Of the 167 respondents, the 59 being treated for hypertension were divided into two groups based on their participation in volunteering. Comparison between the groups showed significant differences in nocturnal awakening, sleep efficiency, and nap frequency. Volunteers had less nocturnal awakening, increased sleep efficiency, fewer naps, and decreased depression. Covariance structure analysis of the survey data and sleep measurements for hypertensive older adults in the volunteer group was performed by modeling the relationships between variables with a path diagram. Our model showed strong goodness of fit (χ2 test = 15.636, p = 0.111, GFI = 0.925, AGFI = 0.842, CFI = 0.925, RMSEA = 0.099). The findings of this study suggest that older adults with hypertension who participate in volunteer activities have less nocturnal awakening, improved sleep quality, and reduced risk of depression, and provides evidence to promote social participation in volunteering among older adults with hypertension.

Effectiveness of current physiotherapy in carpal tunnel syndrome

Carpal Tunnel Syndrome (CTS) is a constellation of symptoms associated with compression of the median nerve at the wrist in the carpal tunnel. The main symptoms of CTS are numbness, pain and tingling of the first three fingers and radial side of the ring finger, nocturnal awakening is due to pain and impaired fine motor control because of weakness of the hand. Until now, the study results in which conservative methods have been applied in the treatment of CTS are contradictory. CTS rehabilitation includes laser therapy, ultrasound therapy, manual therapy, neurodynamic techniques, functional massage, splint, exercises etc. Alternative treatments for CTS include: acupuncture, massages, the Chinese cupping massage. The aim of this review is to explain the current physiotherapy methods applied in CTS patients and the research results on this subject.

Role of Nutritive Factors in Infants Sleep Management

The organized infant’s sleep schedule is the crucial part of normal individual development. On the contrary, restless sleep, nocturnal awakening, long wakefulness can lead to deviations in physical, psychomotor, and cognitive development. Feeding schedule organized according to the time of a day and circadian rhythms (chrono-nutrition concept) can be useful for prevention and correction of such disorders. You are aware of the effect of such factors as feeding before night's sleep, nutrition at dark time of a day, diet enriched with triptophane and nucleotides, on the maturation and consolidation of infants sleep. The correlation between intestinal microbiota and factors affecting the circadian and metabolic activity of the body are presented: day-night cycles, sleep and wake, diet and nutrition. Targeted regulation of the intestinal microbiota through products enriched with functional components (prebiotics) can lead to the development of healthy sleep in infants via axis “brain – intestine – microbiota”.

Association between asthma symptom scores and perceived stress and trait anxiety in adolescents with asthma

Background: Emotional disorders, including depression and anxiety, are more prevalent in individuals with asthma than in the general population and are associated with poor asthma outcomes. Identification of patients with increased levels of stress and anxiety may be helpful when treating asthma and during asthma counseling. Objective: To further characterize the relationship between asthma symptoms and perceived stress and trait anxiety in an adolescent population. Methods: Adolescents (N = 335) ages 14‐17 years were recruited to examine the effect of stress on health measures. They were included in the present analysis if they reported current asthma, defined as self-reported clinician-diagnosed asthma plus one or more episodes of asthma in the past year. Asthma symptoms were assessed on a 7-point scale by using a standardized questionnaire that targets nocturnal awakening due to asthma, symptoms on awakening, activity limitation, shortness of breath, time spent wheezing, and short-acting bronchodilator use. Stress was measured by using the Perceived Stress Scale (PSS), and trait anxiety was measured by using the State-Trait Anxiety Inventory. Linear regression was used to associate asthma symptoms with PSS and trait anxiety. Results: Thirty-eight adolescents (11.3%), with mean ± standard deviation age 16.7 ± 0.9 years, reported current asthma. Four of the six asthma symptom assessments had significant associations with PSS: symptoms on awakening (β = 4.82, p < 0.001), nocturnal awakening due to asthma (β = 4.47, p < 0.001), activity limitation (β = 2.78, p = 0.005), and shortness of breath (β = 1.73, p = 0.014). These associations remained significant after adjusting for gender, race, and the body mass index percentile. Trait anxiety had significant associations with nocturnal awakening (β = 9.28, p = 0.002) and symptoms on awakening (β = 8.74, p = 0.002). Associations remained significant after adjusting for gender, race, and body mass index percentile. Conclusion: Asthma symptom severity is associated with increased perceived stress and trait anxiety. Adolescents with asthma may represent a population that is particularly vulnerable to perceived stress and anxiety, which highlights the importance of considering these factors in asthma counseling.

1126 Relationship Between Headache and Sleep: A Longitudinal Study from the Population of Sao Paulo City (Brazil)

Introduction The complaint of nocturnal awakening with headache (NAH), was prevalent (8.4%) in the São Paulo population and was associated with sleep disturbances, as demonstrated in a study conducted in 2007 (EPISONO). Indeed, this relationship between sleep and headache is well documented in the literature. Objective: To assess the incidence and evolution of NAH and to associate sleep-related variables in an eight-year prospective study. Methods From 1042 volunteers enrolled in the baseline, 712 agreed to participate in the follow-up. Questionnaires and scales were applied and polysomnography and actigraphy performed. The complaint of NAH was analyzed according to a frequency questionnaire and separated into frequent or occasional. Results At follow-up, 110 volunteers reported NAH, of which 82 were the same as those from the baseline, but only 38 had frequent complaints. Comparing with volunteers whose headache has become occasional, we have as a difference the insomnia severity index which is significantly higher in the group with frequent NAH (8.40 ± 5.10 vs 11.20±6.40 p:0.03) and worse sleep quality as measured by the Pittsburgh questionnaire (7.25±3.60 vs 10.25±4.60 p:0.002). In addition, these volunteers had higher anxiety (10.40±9.30 vs 12.00± 10:00 p: 0.008) and depression (10.60±9.90 vs 12:00±9.90 p:0.005) from Beck’s questionnaires and greater fatigue (4.85±3.10 vs 9.75±5.55 p:0.001). The associations of NAH with insomnia, nightmares, and bruxism observed in the baseline continued, but no difference was observed between those who had frequent or occasional complaints at follow-up. Conclusion Our study showed that NAH was highly prevalent in the Sao Paulo population in both the baseline and follow-up studies, but this frequency had a reduction in follow-up. Volunteers who persisted with the frequent complaint showed greater severity of insomnia, higher anxiety and depression and greater fatigue. Support Associação Fundo de Incentivo à Pesquisa (AFIP) and São Paulo Research Foundation (FAPESP)

Hot flashes and awakenings among midlife women

Study Objectives For most women, the menopause is accompanied by hot flashes and sleep problems. Although hot flashes reportedly wake women from sleep, in the few studies that have used objective measures of both sleep and hot flashes, links between hot flashes and nocturnal awakening have been inconsistent. In a well-characterized cohort of midlife women, we examined the association between objectively assessed hot flashes and actigraphically defined wake from sleep. We hypothesized that wake episodes would be more likely during an objective hot flash relative to minutes without a hot flash. Methods Peri- and postmenopausal midlife women underwent simultaneous objective measurement of hot flashes (sternal skin conductance) and sleep (actigraphy) over 24 hours in the home. The likelihood of waking in the minutes during the hot flash relative to the minutes preceding the hot flash was compared using generalized estimating equations. Results We studied 168 women with at least one objective nocturnal hot flash and actigraphy data. Actigraphy-assessed wake episodes were concurrent with 78% of the objective hot flashes. We found an increased likelihood of wake in the minutes during the objective hot flash (0 to +5 min: OR [95% CI] = 5.31 (4.46 to 6.33); p &lt; .0001) relative to the minutes preceding it (–10 to –1 min). The increased likelihood of wake occurred irrespective of whether the women reported the objective hot flash. Conclusion Among these women who underwent objective measurement of sleep and hot flashes, nocturnal wakefulness was observed with the majority of hot flashes.