Snoring and its relationship with asthma burden among inner-city children
Published: June 05, 2021
Asthma is common in childhood, affecting about 1 in 12 children in the United States, and children from disadvantaged communities are disproportionately affected by this disease. Children from these communities are also more likely to suffer from sleep disturbances, including sleep-disordered breathing, and poor sleep habits. Sleep-disordered breathing is a known comorbidity of asthma and is related to worse asthma control and severity. Snoring, which is the primary symptom of sleep-disordered breathing, is more common in children with asthma than those without asthma. However, little is known about the relationship between snoring and asthma burden among inner-city children. It is important to identify risk factors for poor asthma control and healthcare utilization to allow for better overall treatment of asthma in this vulnerable patient population.
In a study recently published in The Journal of Allergy and Clinical Immunology: In Practice, Gunnlaugsson et al. evaluated the relationship between snoring frequency and asthma burden among children enrolled in the School Inner-City Asthma Study (SICAS). Children participating in this study were school-aged and had physician diagnosed asthma. Snoring frequency was assessed at quarterly visits over a 1-year period and categorized as “Never”, “Rare” (1-2 nights a week), “Sometimes” (3-5 nights a week) and “Habitual” (6-7 nights a week). The relationship between snoring frequency and various asthma outcomes was then assessed, adjusting for factors with positive associations with snoring (including common cold, nasal allergy symptoms and BMI), to eliminate their effect on the observed relationship between snoring frequency and asthma outcomes.
The authors found that snoring was very common among this study population, with almost 25% reporting habitual snoring at initial assessment and 37.8% reporting habitual snoring on at least one assessment. Children with habitual snoring had a greater likelihood of suffering from asthma symptoms compared to children with any other frequency of snoring. Those with habitual snoring also had a higher likelihood of hospitalization or unscheduled healthcare visits for asthma and worse overall control of their asthma, compared to children who did not report snoring. Lastly, habitual snoring was associated with missed caregiver sleep and changed caregiver plans, compared to those with no snoring.
This study highlights that snoring frequency, which can be easily assessed, helps identify those children from vulnerable populations who are at risk of worse asthma burden and healthcare utilization.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.