title: Experimentally manipulated sleep duration in adolescents with asthma: Feasibility and preliminary findings.
abstract: OBJECTIVE
  To examine the impact of sleep duration on lung function and asthma symptoms in adolescents.
  
  
  METHODS
  Ten adolescents with asthma (60% female, 60% Caucasian, mean age = 13.7 years, range 12-17) completed a 3-week randomized, cross-over sleep manipulation protocol. Following a week of self-selected sleep duration, adolescents were randomized to a five-night deficient sleep opportunity (6.5 hr in bed) or a healthy sleep opportunity (10 hr in bed) obtained by systematically changing bedtimes. Wake time remained consistent across all 3 weeks (including weekends). Daily reports of sleep patterns and asthma symptoms, actigraphy, and daily peak expiratory flow rates (PEFR), as well as weekly spirometry and exhaled nitric oxide were collected.
  
  
  RESULTS
  Participants averaged 3.2 hr less sleep (P < 0.001) per night in the short sleep condition versus the long sleep condition. Further, they had an 8.4% decrease overnight in PEFR (P = 0.007), and reported more asthma symptoms interfering with activities in the past 24 hr (P = 0.02) in the short sleep condition than the long sleep condition. No significant differences between experimental weeks were found for weekly spirometry or exhaled nitric oxide.
  
  
  CONCLUSIONS
  This pilot study demonstrated the feasibility of a cross-over sleep manipulation protocol in adolescents with asthma. Since overnight decrease in PEFR is a marker of nocturnal asthma, and has been associated with the severity of daytime airflow limitation, these early-stage results suggest that shortened sleep duration may exacerbate adolescent asthma and associated functional impairments.
authors: National Jewish Health, Denver, Colorado.
authors: Lisa J
authors: LJ
authors: Meltzer
authors: National Jewish Health, Denver, Colorado.
authors: Anna
authors: A
authors: Faino
authors: Children's Hospital of Colorado, Aurora, Colorado.
authors: Stanley J
authors: SJ
authors: Szefler
authors: National Jewish Health, Denver, Colorado.
authors: Matthew
authors: M
authors: Strand
authors: National Jewish Health, Denver, Colorado.
authors: Erwin W
authors: EW
authors: Gelfand
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors: Dean W
authors: DW
authors: Beebe
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D001249:Asthma / Q000503:physiopathology*; D018592:Cross-Over Studies; D045853:Exhalation / Q000502:physiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D010865:Pilot Projects; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation / Q000503:physiopathology*; D013147:Spirometry; D013997:Time Factors
chemical_list: D009569:Nitric Oxide
keywords: adolescence; pediatrics; sleep deprivation; sleep extension; teenagers