title: Is wheezing associated with decreased sleep quality in Sri Lankan children? A questionnaire study.
abstract: OBJECTIVE
  To investigate the association between wheezing and impaired sleep in Sri Lankan children, aged 6-12 years; and, to report the prevalence of asthma-related symptoms in these subjects.
  
  
  METHODS
  The International Study of Asthma and Allergies in Childhood questionnaire and a separate sleep questionnaire were completed.
  
  
  RESULTS
  Of 800 originally distributed questionnaires, 652 were analyzed. Wheezing was present in 89 children (14%). Within this group, 66% reported wheezing in the last 12 months. Wheezing children had a significantly higher presence of snoring, restless sleep, nocturnal awakenings and daytime tiredness. Wheezing was found to be independently associated with restless sleep (odds ratio (OR) = 2.4). There was no association between wheezing and difficulties falling asleep, nocturnal awakenings, apneas, and daytime sleepiness and tiredness. After adjusting for possible confounders, the following significant associations were present: snoring and apneas (OR = 1.6), chronic rhinitis and apneas (OR = 1.6), snoring and restless sleep (OR = 3.2), chronic rhinitis and restless sleep (OR = 2.1), and hayfever and daytime tiredness (OR = 4.3). Wheezing was related to an increased risk of snoring (OR = 2.8) and subjects with chronic rhinitis had also an increased risk of snoring (OR = 1.7), adjusting for possible confounders.
  
  
  CONCLUSIONS
  The sleep of wheezing children was impaired compared with their non-wheezing peers, resulting in an increased prevalence of daytime tiredness. Upper airway symptoms, such as chronic rhinitis or hayfever, should be carefully considered in these children, as they might be responsible for these sleep problems.
authors.affiliation: Department of Pediatrics, University of Antwerp, Belgium. stijn.verhulst@ua.ac.be
authors.forename: S L
authors.initials: SL
authors.lastname: Verhulst
authors.forename: K
authors.initials: K
authors.lastname: Vekemans
authors.forename: E
authors.initials: E
authors.lastname: Ho
authors.forename: L
authors.initials: L
authors.lastname: Aerts
authors.forename: S
authors.initials: S
authors.lastname: Jacobs
authors.forename: L A
authors.initials: LA
authors.lastname: De Backer
authors.forename: H
authors.initials: H
authors.lastname: Dhanapala
authors.forename: P
authors.initials: P
authors.lastname: Perera
authors.forename: W A
authors.initials: WA
authors.lastname: De Backer
authors.forename: K N
authors.initials: KN
authors.lastname: Desager
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D012135:Respiratory Sounds / Q000503:physiopathology*; D012890:Sleep; D013188:Sri Lanka; D011795:Surveys and Questionnaires