The relationship of daily sleep to respiratory symptoms and lung function in children with asthma

The purpose of this dissertation research includes (1) summarizing existing knowledge regarding sleep in school age children with asthma, (2) providing an overview of statistical methods commonly used by researchers for the analysis of daily measured continuous data, and (3) examining temporal daily patterns of sleep, respiratory symptoms, and pulmonary function in children with and without asthma. This dissertation consisted of three papers. The first paper was a literature review on the topic of sleep in children with asthma. The second study compared four different statistical methods in analyzing daily measured data with a data example. The third study was a secondary analysis of an existing data set. Data were collected from 28 children with and 27 without asthma, who were 9 to 11 years old. All children kept self-report diaries assessing sleep, respiratory symptoms, and peak expiratory flow and wore wrist actigraphs during seven days/six nights at home-monitoring period. For all sleep measures, the within-child variability was larger than the between-child variability. Increases in daytime respiratory symptoms were predictive of both greater amount of wakefulness after sleep onset and lower sleep efficiency the following night. Additionally, increases in nighttime respiratory symptoms were associated with decreases in perceived sleep quality that night. Peak expiratory flow measures were not predictive of either objectively measured sleep or subjective perception of sleep quality. In contrast, there was no evidence that poor sleep on one night would lead to increased respiratory symptoms or lower peak expiratory flow the following day. Interventions targeting respiratory symptoms during the day and at night may be useful in the treatment of sleep disturbances in children with asthma.