Format

Send to

Choose Destination
Arch Pediatr Adolesc Med. 2011 Sep;165(9):826-30. doi: 10.1001/archpediatrics.2011.139.

Controller medication use and sleep problems in pediatric asthma: a longitudinal case-crossover analysis.

Author information

1
Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, WA 98145, USA. michelle.garrison@seattlechildrens.org

Abstract

OBJECTIVE:

To determine the effect of asthma controller medication use, choice, and adherence on sleep in children with asthma.

DESIGN:

A case-crossover analysis examining within-subject differences in controller use between time points with and without sleep problems, based on survey data from 3 time points (baseline, 6 months, and 1 year) of a randomized trial.

SETTING:

Families were recruited from 2 area practice networks; all assessments were completed by parents online.

PARTICIPANTS:

Children with asthma, aged 2 to 10 years, as identified by asthma-related medical encounters and prescription fills.

MAIN EXPOSURES:

Parent report of asthma controller medication use (yes/no), type (inhaled corticosteroid or leukotriene inhibitor), and adherence (daily use, nonadherent use, or nonuse).

MAIN OUTCOME MEASURES:

Children's sleep problems, as defined by parent report regarding how often the child had difficulty falling asleep or experienced daytime sleepiness.

RESULTS:

The analysis included 482 children; 82.6% and 75.9% completed the 6-month and 1-year follow-up visits, respectively. Sleep problems were common, with 19.4% of parents at baseline reporting frequent problems with the child falling asleep and 12.1% reporting frequent daytime sleepiness. Compared with children who did not use a controller medication, children had a decreased risk of problems falling asleep during periods with daily controller use (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.13-0.92), with a trend toward an effect in those with nonadherent use (0.47; 0.20-1.12). Any controller use, regardless of adherence, was also associated with decreased odds of daytime sleepiness (OR, 0.69; 95% CI, 0.51-0.94). When controller class was examined, leukotriene inhibitors were associated with significantly decreased odds of problems falling asleep (OR, 0.18; 95% CI, 0.04-0.78), with or without concomitant use of inhaled corticosteroids, but the results for use of inhaled corticosteroids alone were not statistically significant (0.69; 0.32-1.53).

CONCLUSIONS:

Controller medications appear to be effective in reducing sleep problems in children with asthma, and leukotriene inhibitor medications may be especially effective in this population.

PMID:
21893649
DOI:
10.1001/archpediatrics.2011.139
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center