title: Sleep-disordered breathing and asthma: evidence from a large multicentric epidemiological study in China.
abstract: BACKGROUND
  Previous studies have postulated that sleep-disordered breathing (SDB) may be associated with the occurrence and exacerbation of asthma. However, there was limited quantitative evidence on the topic. This study aimed at investigating the prevalence and predisposing factors of asthma, and quantifying the association between SDB and asthma among school-aged children in China. In addition, a comprehensive meta-analysis of the published evidences and our findings were further conducted.
  
  
  METHODS
  To test the hypothesis, we conducted a multicentric cross-sectional study involving 22,478 children aged 5-12 years recruited from eight cities in China. Furthermore, a meta-analysis based on both previously published studies and our cross-sectional study was performed.
  
  
  RESULTS
  The prevalence rate of SDB and asthma was 12.0% and 3.5% among our cross-sectional study sample. It was demonstrated that symptoms of SDB, such as habitual snoring (OR = 1.28, 95%CI: 1.01-1.62), and obstructive sleep apnea (OSA) (OR = 1.92, 95%CI: 1.34-2.76), were significantly associated with asthma, after adjusting for potential confounding factors. In the meta-analysis, SDB was correlated with the prevalence of asthma in both children (OR = 1.58, 95%CI: 1.35-1.80) and adults (OR = 1.55, 95%CI: 1.42-1.67).
  
  
  CONCLUSIONS
  Our results provide further evidence for the independent association between SDB and asthma. The clinical significance of our findings lies in the emphasis that children undergoing examination or treatment for asthma should be routinely screened for sleep problems. Further systematic study is required to illuminate the underlying mechanism.
authors.affiliation: Xin Hua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. tiffanyli_sjtu@126.com.|School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200127, PR China. tiffanyli_sjtu@126.com.
authors.forename: Liwen
authors.initials: L
authors.lastname: Li
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia. xzw_xu@126.com.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China. zhujing7@sh163.net.
authors.forename: Xingming
authors.initials: X
authors.lastname: Jin
authors.affiliation: Xin Hua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. yanchk@gmail.com.
authors.forename: Chonghuai
authors.initials: C
authors.lastname: Yan
authors.affiliation: Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China. riversailer@sina.com.
authors.forename: Fan
authors.initials: F
authors.lastname: Jiang
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia. s.tong@qut.edu.au.
authors.forename: Shilu
authors.initials: S
authors.lastname: Tong
authors.affiliation: MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai, 200092, China. shenxm9907@126.com.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Shen
authors.affiliation: School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200127, PR China. Lsh9907@163.com.|MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai, 200092, China. Lsh9907@163.com.
authors.forename: Shenghui
authors.initials: S
authors.lastname: Li
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology*; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology