title: Asthma and subjective sleep disordered breathing in a large cohort of urban adolescents.
abstract: Sleep disordered breathing (SDB) has not been well studied in urban adolescents with asthma in community settings. Nor has the association of SDB symptoms and asthma severity been studied. We characterized self-reported symptoms suggesting SDB and investigated the association of SDB symptoms, probable asthma, and asthma severity.
  
  
  
  9,565 adolescents from 21 inner-city high schools were screened for an asthma intervention study. Students reported on symptoms suggesting SDB using questions from the 2007 NHANES, if they were ever diagnosed with asthma, and on asthma symptoms. Using generalized linear mixed models with logit link with school as a random intercept and adjusting for age, gender, and race/ethnicity, we examined associations of SDB symptoms, and demographic characteristics, probable asthma, and asthma severity.
  
  
  
  12% reported SDB symptoms. Older and bi-racial participants (compared to Caucasian) had higher odds of symptoms suggesting SDB (p <.001). Compared to those without probable asthma, adolescents with probable asthma had 2.63 greater odds of reporting SDB symptoms (p <.001). Among those with probable asthma, the odds of reporting SDB symptoms increased with asthma severity. When exploring daytime severity and severity due to night wakening separately, results were similar. All results remained significant when controlling for age, gender, and ethnicity.
  
  
  
  In a large urban community cohort of predominately ethnic minority adolescents, self-reported SDB symptoms were associated with probable asthma and increased asthma severity. This study highlights the importance of SDB as a modifiable co-morbidity of asthma.
authors.affiliation: a Department of Pediatrics , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Stephanie O
authors.initials: SO
authors.lastname: Zandieh
authors.affiliation: b New York University College of Global Public Health , New York , NY , USA.
authors.forename: Amarilis
authors.initials: A
authors.lastname: Cespedes
authors.affiliation: c Department of Child and Adolescent Psychiatry , New York University School of Medicine , New York , NY , USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Ciarleglio
authors.affiliation: d Department of Pediatrics , Columbia University College of Physicians and Surgeons , New York , NY , USA.
authors.forename: Wallace
authors.initials: W
authors.lastname: Bourgeois
authors.affiliation: e Division of Pulmonary , Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Rapoport
authors.affiliation: f Department of Scholarship and Research , Columbia University School of Nursing , New York , NY , USA.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Bruzzese
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D011203:Poverty; D044469:Racial Groups; D012720:Severity of Illness Index; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000208:ethnology*; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Co-morbidities; asthma severity; cross-sectional; inner city; snoring