Medical Student University of Rochester School of Medicine and Dentistry University of Rochester Rochester, New York, United States
Background: Asthma is one of the most common chronic childhood conditions, and many children with asthma experience worsening symptoms at night that may disrupt their sleep. About half of children with severe asthma have at least 1 night of inadequate sleep per week. Few studies have explored how sleep disruptions due to asthma may impact daily functioning in teens.
Objective: To identify associations between nocturnal asthma awakenings and functional health outcomes such as physical activity, mood, school attendance, and quality of life in a cohort of teenagers with asthma.
Design/Methods: We analyzed baseline data from School-Based Asthma Care for Teens (SB-ACT), an NIH-funded RCT conducted from 2014-2018 in Rochester, NY. During an at-home baseline survey, teenagers (ages 12-16) with asthma answered questions about demographics, recent asthma symptoms, and functional health outcomes. We conducted bivariate and multivariate regression analyses to explore the relationship between persistent nocturnal asthma symptoms (>2 nights of nocturnal asthma awakenings in the past 14 days) and functional health measures.
Results: Data were collected and analyzed from 430 teens (Participation Rate 79%, Mean Age 13.4 yrs, 56% Male, 56% African American, 84% Medicaid Insurance; Table 1). Almost 1/3 (30%) of teens reported persistent nocturnal asthma symptoms. Compared to teens with intermittent nocturnal asthma symptoms, teens with persistent nocturnal asthma were more likely to report physical activity limitations during strenuous activities (58% vs 41%, p<0.01) moderate activities (32% vs 19%, p<0.01), and school gym (36% vs 19%, p<0.01). These teens were also more likely to report depressive symptoms (41% vs 23%, p<0.01), more asthma related school absences in the past 14 days (0.81 vs 0.12, p<0.01) and poorer quality of life (4.6 vs 5.9, p<0.01; range 0-7 points). These findings remained significant when controlling for daytime asthma symptoms, weight status, race, ethnicity, gender, age, and smoke exposure (Table 2). Conclusion(s): Persistent nighttime asthma symptoms were associated with poor functional health outcomes among teens, independent of day-time symptoms. Although causation cannot be inferred from this cross-sectional study, these findings suggest that night-time symptoms disrupt sleep and may play a role in daily activities and wellness. Identifying nighttime symptoms and improving asthma control at night may positively impact daily functioning for these teens.
Authors/Institutions: Anne Zhang, University of Rochester, Rochester, New York, United States; Maria Fagnano, University of Rochester, Rochester, New York, United States; Sean M. Frey, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States; Jill Halterman, University of Rochester School of Medicine, Rochester, New York, United States
