 |
|
Nocturnal Asthma in Children Affects School Attendance, School Performance, and Parents' Work Attendance
Gregory B. Diette, MD, MHS;
Leona Markson, ScD;
Elizabeth A. Skinner, MSW;
Theresa T. H. Nguyen, MD, MS;
Pamela Algatt-Bergstrom, PharmD;
Albert W. Wu, MD, MPH
Arch Pediatr Adolesc Med. 2000;154:923-928.
Context Asthma symptoms that occur at night may signal worse asthma control, but the nighttime occurrence may have additional clinical significance. To date, however, there have been few studies of the impact of nocturnal awakening from asthma on children with the disease, including problems with daytime functioning.
Objective To determine if school absenteeism and school performance in children and work absenteeism in their parents are associated with nocturnal awakenings from asthma.
Design Cross-sectional survey during the winter of 1997 through 1998.
Setting Three managed care organizations in the United States.
Participants Parents of 438 children with asthma, aged 5 to 17 years, who were enrolled in managed care organizations.
Intervention None.
Main Outcome Measures Parent's reports of number of days their child missed school and parent missed work and how often the child's education suffered because of asthma in the past 4 weeks.
Results Overall, more than 40% of children had nocturnal awakenings from asthma in the past 4 weeks. Multivariate analyses were performed that adjusted for child age, race, overall symptom severity, and use of reliever medications. Compared with children who did not awaken from asthma, there were greater odds of missed school days in children who awakened 1 to 3 nights (odds ratio [OR], 3.6; 95% confidence interval [CI], 2.1-6.2), 4 to 7 nights (OR, 4.4; 95% CI, 2.0-10.0), and more than 7 nights (OR, 14.7; 95% CI, 5.9-37.0). Similarly, there were greater odds of education suffering in children who awakened 1 to 3 nights (OR, 2.3; 95% CI, 1.4-3.7), 4 to 7 nights (OR, 2.1; 95% CI, 0.9-4.6), and more than 7 nights (OR, 2.3; 95% CI, 1.0-5.4), and parents missing work in children who awakened 1 to 3 nights (OR, 4.0; 95% CI, 2.2-7.1), 4 to 7 nights (OR, 6.5; 95% CI, 2.7-16), and more than 7 nights (OR, 3.2; 95% CI, 1.3-7.9). Greater overall symptom severity and high use of reliever mediation were also associated with missed school, education suffering, and parent absenteeism.
Conclusions Nighttime awakenings in children with asthma may affect school attendance and performance, as well as work attendance by parents. Nighttime symptoms have independent prognostic value, even when overall asthma symptom severity is accounted for. By addressing whether there are nighttime awakenings in children with asthma, clinicians may be able to tailor the therapeutic regimen to counter these symptoms.
From the Divisions of Pulmonary and Critical Care Medicine (Dr Diette) and General Medicine (Dr Wu), and the Department of Pediatrics (Dr Nguyen), School of Medicine, and the Departments of Epidemiology (Drs Diette and Wu) and Health Policy and Management (Ms Skinner and Dr Wu), School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Md; and Merck & Co Inc, West Point, Pa (Drs Markson and Algatt-Bergstrom).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Family--school connections and internalizing problems among children living with asthma in urban, low-income neighborhoods
Murdock et al.
J Child Health Care 2009;13:275-294.
ABSTRACT
The Effects of Timing of Pediatric Knee Ligament Surgery on Short-term Academic Performance in School-Aged Athletes
Trentacosta et al.
Am J Sports Med 2009;37:1684-1691.
ABSTRACT
| FULL TEXT
School Absenteeism, Health Status, and Health Care Utilization Among Children With Asthma: Associations With Parental Chronic Disease
Lipstein et al.
Pediatrics 2009;123:e60-e66.
ABSTRACT
| FULL TEXT
School Performance: The Pediatrician's Role
Bravender
CLIN PEDIATR 2008;47:535-545.
ABSTRACT
Sleep Disruptions in Parents of Children and Adolescents with Chronic Illnesses: Prevalence, Causes, and Consequences
Meltzer and Moore
J Pediatr Psychol 2008;33:279-291.
ABSTRACT
| FULL TEXT
Internet Telehealth for Pediatric Asthma Case Management: Integrating Computerized and Case Manager Features for Tailoring a Web-Based Asthma Education Program
Wise et al.
Health Promot Pract 2007;8:282-291.
ABSTRACT
An Intervention to Increase the Use of Asthma Action Plans in Schools: A MASNRN Study
Pulcini et al.
The Journal of School Nursing 2007;23:170-176.
ABSTRACT
| FULL TEXT
Testing the Acceptance of Asthma Model With Children and Adolescents
Kae Kintner
West J Nurs Res 2007;29:410-431.
ABSTRACT
Impact of a Child's Chronic Illness on Maternal Sleep and Daytime Functioning.
Meltzer and Mindell
Arch Intern Med 2006;166:1749-1755.
ABSTRACT
| FULL TEXT
Assessment of Asthma Severity and Asthma Control in Children
Yawn et al.
Pediatrics 2006;118:322-329.
ABSTRACT
| FULL TEXT
A controlled trial of a school-based intervention to improve asthma management
McCann et al.
Eur Respir J 2006;27:921-928.
ABSTRACT
| FULL TEXT
Deprivation, smoking, and quality of life in asthma
Austin et al.
Arch. Dis. Child. 2005;90:253-257.
ABSTRACT
| FULL TEXT
Asthma Inhalers in Schools: Rights of Students with Asthma to a Free Appropriate Education
Jones and Wheeler
AJPH 2004;94:1102-1108.
ABSTRACT
| FULL TEXT
Health consequences associated with frequent wheezing in adolescents without asthma diagnosis
Yeatts et al.
Eur Respir J 2003;22:781-786.
ABSTRACT
| FULL TEXT
Health Consequences for Children With Undiagnosed Asthma-like Symptoms
Yeatts et al.
Arch Pediatr Adolesc Med 2003;157:540-544.
ABSTRACT
| FULL TEXT
Invited Commentary: Attendance and Absence as Markers of Health Status--The Example of Active and Passive Cigarette Smoking
Alberg et al.
Am J Epidemiol 2003;157:870-873.
FULL TEXT
Health-Related Quality of Life of Severely Obese Children and Adolescents
Schwimmer et al.
JAMA 2003;289:1813-1819.
ABSTRACT
| FULL TEXT
Internet-Enabled Interactive Multimedia Asthma Education Program: A Randomized Trial
Krishna et al.
Pediatrics 2003;111:503-510.
ABSTRACT
| FULL TEXT
Nocturnal Asthma
Calhoun
Chest 2003;123
:399S-405S.
ABSTRACT
| FULL TEXT
Environmental Epidemiology of Pediatric Asthma and Allergy
Cole Johnson et al.
Epidemiol Rev 2002;24:154-175.
FULL TEXT
Association of Air Pollution With School Absenteeism Due to Illness
Park et al.
Arch Pediatr Adolesc Med 2002;156:1235-1239.
ABSTRACT
| FULL TEXT
The prevalence and management of asthma in primary-aged schoolchildren in the south of England
McCann et al.
Health Educ Res 2002;17:181-194.
ABSTRACT
| FULL TEXT
Integrating Environmental Justice and the Precautionary Principle in Research and Policy Making: The Case of Ambient Air Toxics Exposures and Health Risks among Schoolchildren in Los Angeles
Morello-Frosch et al.
The ANNALS of the American Academy of Political and Social Science 2002;584:47-68.
ABSTRACT
|
