Asthma is the leading chronic disease in pediatric minority patients, affecting over 4 million children. Our data is from a randomized controlled trial of community intervention measured by self-perceived QOL at baseline, 3, and 6 months. An urban setting with mostly minority patients was used. As part of QOL we collected data on sleep quality.
Previously validated QOL questionnaires were administered by research assistants to children (aged 5–18) and caregivers. Caregivers completed PACQLQ (13 questions) and patients completed PAQLQ (23 questions). Variables followed included missed school days, ER visits, hospitalizations, quality of sleep, use of systemic steroids, and activity limitation. The intervention group had community support by health educators. The results were compared by means tests and student t-tests. Urban children from Camden ages 5–18; mean age 11.08. 37.9% of patients live below the poverty line. 60.4% Hispanic, 35.9% African-American, 3.8% other. N=53, 18 of whom completed the study.
HRQOL increased for patients and caregivers as quality of sleep improved. Patients and caregivers with poor sleep showed QOL decreases of 10.5% and 45.6% respectively throughout the study. Patient perceived QOL increased with fair sleep (31.5%) and good sleep (11.7%), while caregiver perceived QOL increased 42.7% with fair sleep and 6.7% with good sleep (P < 0.01). No other variables correlated with improvement in self-perceived QOL.
While there can be many reasons - including obstructive sleep apnea - for poor sleep quality, uncontrolled asthma is often the reason for poor sleep in urban asthmatic children. More detailed sleep questionnaires including environmental factors, sleeping arrangements, and sleep hygiene need to be obtained in asthmatic children to further elucidate these findings.
Nighttime symptoms have been documented to correlate with asthma control in both adults and children. Most primary care practices do not specifically ask about quality of sleep. Our data indicates that questions about quality of sleep need to be incorporated into well visits for pediatric asthma patients, especially in the urban setting.
Vatsala Ramprasad, No Financial Disclosure Information; No Product/Research Disclosure Information