An attempt to identify the sleep related disorders in asthmatic children

Vidhyasagar K., Subash Sundar


Background: Asthma is the most common chronic respiratory disorder of children. A significant feature that has not received the attention it deserves is the effect of asthma on quality of sleep itself and the consequent adverse effect on individuals’ performance in day to day activities. Increased daytime sleepiness and tiredness because of frequent nocturnal awakenings has been documented even in clinically stable asthmatic children. Hence this study is an attempt at identifying the prevalence of sleep related disorders in asthmatic children and once identified the therapy can be directed towards these nocturnal symptoms so that these children have a better sleep quality and day time performance.

Methods: 125 asthmatic children in the age of 3 – 12 years as per the criteria IAP asthma by consensus attending the outpatient department of a tertiary care centre were classified into the category of asthma. The parents of the children were given the questionnaire sleep disturbance scale for children (SDSC) and were asked to recall the sleep related questions in the preceding 6 month period.

Results: Out of the 125 children, 115 (92.0%) of children overall had significant sleep disturbance. The areas of sleep affected were disorders of initiating and maintaining sleep (88.8%); sleep wake transition disorders (87.2%) and disorders of excessive somnolence (89.6%). The use of inhaled corticosteroids with long acting beta 2 agonists showed a reduction of sleep related disorders in these children.

Conclusions: It can be concluded that there is significant sleep disturbances in asthmatic children. These children have difficulty in initiating sleep and also have excessive daytime sleepiness and tiredness due to poor quality of sleep.


Asthma, Sleep, SDSC

Full Text:



Nelson Textbook of Pediatrics - Robert M. Kliegman, Bonita M.D. Stanton, Joseph St. Geme, Nina F Schor.

Chugh IM, Khanna P, Shah A. Nocturnal symptoms and sleep disturbances in clinically stable asthmatic children. Asian Pac J Allergy Immunol Launched Allergy Immunol Soc Thail. 2006;24(2-3):135-42.

Indian Academy of Pediatrics (IAP). [Internet]. Available from:

Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The Sleep Disturbance Scale for Children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251-61.

Pal R, Dahal S, Pal S. Prevalence of Bronchial Asthma in Indian Children. Indian J Community Med Off Publ Indian Assoc Prev Soc Med. 2009;34(4):310-6.

Chakravarthy S, Singh RB, Swaminathan S, Venkatesan P. Prevalence of asthma in urban and rural children in Tamil Nadu. Natl Med J India. 2002;15(5):260-3.

Van Maanen A, Wijga AH, Gehring U, Postma DS, Smit HA, Oort FJ, et al. Sleep in children with asthma: results of the PIAMA study. Eur Respir J. 2013;41(4):832-7.

Van Maanen A, Wijga AH, Gehring U, Postma DS, Smit HA, Oort FJ, et al. Sleep in children with asthma: results of the PIAMA study. Eur Respir J. 2013;41(4):832-7.

Fagnano M, Bayer AL, Isensee CA, Hernandez T, Halterman JS. Nocturnal asthma symptoms and poor sleep quality among urban school children with asthma. Acad Pediatr. 2011;11(6):493-9.

Li Z, Huang IC, Thompson L, Tuli S, Huang S-W, DeWalt D, et al. The relationships between asthma control, daytime sleepiness, and quality of life among children with asthma: a path analysis. Sleep Med. 2013;14(7):641-7.

Garrison MM, Lozano P, Christakis DA. Controller medication use and sleep problems in pediatric asthma: A longitudinal case-crossover analysis. Arch Pediatr Adolesc Med. 2011;165(9):826-30.

Mahajan P, Pearlman D, Okamoto L. The effect of fluticasone propionate on functional status and sleep in children with asthma and on the quality of life of their parents. J Allergy Clin Immunol. 1998;102(1):19-23.

Van De Water ATM, Holmes A, Hurley DA. Objective measurements of sleep for non-laboratory settings as alternatives to polysomnography – a systematic review. J Sleep Res. 2011;20(1pt2):183-200.

Blackwell T, Redline S, Ancoli-Israel S, Schneider JL, Surovec S, Johnson NL, et al. Comparison of Sleep Parameters from Actigraphy and Polysomnography in Older Women: The SOF Study. Sleep. 2008;31(2):283-91.

Aurora RN, Zak RS, Karippot A, Lamm CI, Morgenthaler TI, Auerbach SH, et al. Practice Parameters for the Respiratory Indications for Polysomnography in Children. Sleep. 2010;34(3):379-88.