Influence of asthma on sleep disordered breathing in children: A systematic review

The objective of this study was to perform a systematic review for the association between asthma and sleep disordered breathing (SDB) in children. We performed an electronic search in Medline, Embase, CINAHL, LILACS and Cochrane databases. Study selection criteria: children <18 y of age with diagnosis of asthma and SDB. Primary outcomes: odds ratios (OR) and 95% confidence intervals [95%CI] of asthma for SDB were calculated. There were n = 968 citations identified, of them n = 17 studies were selected, which included n = 45 155 (53% males) children. All included studies defined asthma and SDB based on questionnaires, and only two performed a sleep study for diagnosing obstructive sleep apnea. Mean age was 8.6 +/- 2.5 y. SDB was significantly more frequent in children with asthma compared with non-asthmatics: 23.9% vs 16.7% respectively, p < 0.0001. Children with asthma had a significantly higher risk for SDB: OR 1.9 [1.7; 2.2]. This systematic review showed evidence of a significant association between asthma and SDB in children. Asthma seems to be a significant risk factor for developing SDB. However, the minority of the studies based the diagnosis of SDB on polysomnography, considered the current gold standard for SDB. The physiological and temporal relationships between both conditions should be addressed in future cohort studies. (C) 2014 Elsevier Ltd. All rights reserved.