Nighttime Sleep and Daytime Nap Patterns in School Age Children with and Without Asthma

Department of Family and Child Nursing, University of Washington School of Nursing, Seattle, WA 98195, USA.
Journal of developmental and behavioral pediatrics: JDBP (Impact Factor: 2.13). 09/2008; 29(5):338-44. DOI: 10.1097/DBP.0b013e318182a99e
Source: PubMed


This research examines subjective and objective report of naps and nighttime sleep in 9- to 11-year-old children with and without asthma.
This between subjects study collected prospective self-report diary and objective actigraphy measures of sleep from 27 children with and 27 without asthma during a 7-day/6-night at-home monitoring period.
Thirty-two percent of participants reported daytime naps. Nappers were more likely to be children with asthma (12/27 vs. 5/27, p = 0.04) even though the children with asthma did not report being more tired, sleepy, or less alert in the morning. Nappers did not differ from non-nappers on self-report measures of overall sleep quality or number of awakenings but were documented, via objective measures, to have later (clock time: 23:05 vs. 22:21, p = 0.04) and more variable (Levine's Test for Equality of Variances: F = 10.68, p = 0.002) sleep onset times than non-nappers. Sleep offset times did not differ between the nappers vs. non-nappers, therefore, nappers had fewer total minutes of nighttime sleep than did the non-nappers (437 vs. 465, p = 0.04). Later (clock time: 23:01 vs. 22:15, p = 0.01) sleep onset times were also documented in minority vs. Caucasian children.
Napping appears a more common behavior than expected especially in children with asthma or of minority ethnicity but the reasons are unclear. Self-report measures may not capture important sleep characteristics that objective measures can identify. Strategies to reduce late and variable bedtimes of all children are needed given our awareness of the negative cognitive, emotional, and behavioral consequences of poor sleep in children.

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Available from: Teresa M Ward, Oct 12, 2015
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    • "This study is a secondary analysis of data obtained from two research projects that examined sleep quality in children with JIA (Ward et al., 2008, 2010) and in children with and without asthma (Kieckhefer et al., 2008, 2009). Human subjects approval for the studies was obtained from the Institutional Review Boards at Seattle ChildrenÕs Hospital (JIA study) and the University of Washington (asthma study). "
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    ABSTRACT: The aims of this study were to evaluate sensitivity, specificity and accuracy with an epoch-by-epoch comparison of polysomnography (PSG) and actigraphy with activity counts scored at low, medium and high thresholds, and to compare PSG-derived total sleep time (TST), sleep efficiency (SE) and wake after sleep onset (WASO) to the same variables derived from actigraphy at low, medium and high thresholds in 9- to 11-year-old children with juvenile idiopathic arthritis (JIA), asthma and healthy control children. One night of PSG and actigraphy were recorded. Pairwise group comparisons for sensitivity showed significant differences at the low [Tukey's honest significant difference (HSD) P < 0.002], medium (P < 0.001) and high thresholds (P < 0.001) between JIA and asthma groups, and at the high threshold between JIA and controls (P < 0.009). Significant differences were found for specificity at the low (P < 0.001), medium (P < 0.001) and high thresholds (P < 0.001) between JIA and asthma groups, and between JIA and controls (low, P < 0.002: medium, P < 0.002: high, P < 0.008 threshold). PSG TST, WASO and SE were not significantly different among the groups, but significant group differences were found for actigraphy TST, WASO and SE at all three thresholds. Actigraphy showed the least overestimation or underestimation of sleep or wakefulness at the medium threshold for TST and WASO for all three groups. Compared to PSG, actigraphy was most accurate in the identification of sleep from wakefulness in 9- to 11-year-old healthy children, and less accurate in children with JIA and asthma.
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    ABSTRACT: To examine the associations of child and family sociodemographic characteristics with preschooler bedtime routines. We use parent-report data of 3217 3-year-old children (48% black, 26% Hispanic, and 22% white) from the Fragile Families and Child Wellbeing Study to examine whether child and family characteristics are associated with the presence, time, and consistency of bedtime routines. More than 80% of sample children have a bedtime yet only two thirds follow it. After extensive controls for maternal education, family structure, and other household characteristics, black and Hispanic children have later bedtimes than white children and reduced odds of using regular bedtimes (by 22% and 29%, respectively) and using bedtime routines (by 47% and 33%, respectively). Low maternal education, increased household size, and poverty are associated with decreased use of parent-child interactive and hygiene-related bedtime routines. Children from disadvantaged households are less likely to have consistent bedtime routines than their more advantaged counterparts. This may contribute to later disparities in sleep quality, duration and timing, factors known to be associated with adverse behavioral, cognitive, and health outcomes.
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    ABSTRACT: Objective: It has been reported that the sleep apnea syndrome in the asthmatic patients is prevalent, however, the systematic study in this field using polysomnography has rarely been performed. The aim of this study is to investigate the relationship between the apnea-hypopnea index (AHI) and the pulmonary function in asthmatic children. Methods: This study enrolled 19 male and 12 female asthmatic children aged 6-13 years (average years old). Complete overnight polysomnography and pulmonary function test were performed for the participants. Results: Of the 31 asthmatic children, 21 (67.7%) met the diagnostic criteria of the pediatric sleep apnea and the average AHI was . The children with higher AHI showed poorer pulmonary function (/FVC ratio: p=0.002, %pred: p=0.047). Conclusion: These results suggest that the prevalence of the pediatric sleep apnea could be very high among the asthmatic children and the severity of the sleep apnea correlates with the pulmonary function. However, the case-control study to compare the AHI between the asthma and control groups is absolutely necessary because few normative data are available for the children.
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