title: Nocturnal asthma symptoms and poor sleep quality among urban school children with asthma.
abstract: OBJECTIVE
  The aim of this study was to describe nocturnal asthma symptoms among urban children with asthma and assess the burden of sleep difficulties between children with varying levels of nocturnal symptoms.
  
  
  METHODS
  We analyzed baseline data from 287 urban children with persistent asthma (aged 4-10 years) enrolled in the School-Based Asthma Therapy trial; Rochester, New York. Caregivers reported on nocturnal asthma symptoms (number of nights/2 weeks with wheezing or coughing), parent quality of life (Juniper's Pediatric Asthma Caregivers Quality of Life Questionnaire), and sleep quality by using the validated Children's Sleep Habits Questionnaire. We used bivariate and multivariate statistics to compare nocturnal asthma symptoms with sleep quality/quantity and quality of life.
  
  
  RESULTS
  Most children (mean age, 7.5 years) were black (62%); 74% had Medicaid. Forty-one percent of children had intermittent nocturnal asthma symptoms, 23% mild persistent, and 36% moderate to severe. Children's average total sleep quality score was 51 (range, 33-99) which is above the clinically significant cutoff of 41, indicating pervasive sleep disturbances among this population. Sleep scores were worse for children with more nocturnal asthma symptoms compared with those with milder symptoms on total score, as well as several subscales, including night wakings, parasomnias, and sleep disordered breathing (all P < .03). Parents of children with more nocturnal asthma symptoms reported their child having fewer nights with enough sleep in the past week (P = .018) and worse parent quality of life (P < .001).
  
  
  CONCLUSIONS
  Nocturnal asthma symptoms are prevalent in this population and are associated with poor sleep quality and worse parent quality of life. These findings have potential implications for understanding the disease burden of pediatric asthma.
authors.affiliation: Department of Pediatrics and the Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. maria_fagnano@urmc.rochester.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Fagnano
authors.forename: Alison L
authors.initials: AL
authors.lastname: Bayer
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Isensee
authors.forename: Telva
authors.initials: T
authors.lastname: Hernandez
authors.forename: Jill S
authors.initials: JS
authors.lastname: Halterman
mesh_terms: D001249:Asthma / Q000150:complications* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009518:New York / Q000453:epidemiology; D010290:Parents / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D012574:Schools; D018434:Sickness Impact Profile; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology*; D014505:Urban Population