Associations of Sleep Problems With Asthma/wheeze and Allergic Rhinitis Among Chinese Children Aged 0-6 Years: a Cross-sectional Study

Background: Asthma/wheeze and allergic rhinitis are common among pre-school age children, which urgently need to identify more modifiable risk factors for prevention. The aim of this study was to examine the associations of sleep problems with asthma/wheeze and allergic rhinitis among Chinese children aged 0-6 years. Methods: : This cross-sectional survey, a part of the National Survey on Physical Growth and Development of Children in nine cities of China (NSPGDC), was conducted in Guangzhou, China. Children aged 0-6 years were randomly selected from 29 communities and 32 kindergartens. Asthma/wheeze, allergic rhinitis and sleep problem were evaluated by a valid questionnaire which was completed by participants’ parent(s). Binary logistic regression models were employed to estimate the odds ratios (OR) and 95% confidence intervals (CI) for asthma/wheeze and allergic rhinitis according to short sleep duration, late bedtime and frequent nocturnal awaking. Results: : We included 13376 children aged 0~6 years. Of these, 371 (2.8%) diagnosed as asthma/wheeze, and 610 (4.6%) diagnosed as allergic rhinitis. Frequent nocturnal awakening was associated with asthma/wheeze and allergic rhinitis, adjusted OR were 1.53 (95% CI: 1.20~1.94) and 1.39(1.14-1.71), respectively. Further subgroup analysis showed the association of frequent nocturnal awakening with asthma/wheeze and allergic rhinitis differed by age. No significant associations of short duration and late bedtime with asthma/wheeze and allergic rhinitis were identified. Conclusions: : Our data suggested that frequent nocturnal awakening was associated with asthma/wheeze and allergic rhinitis, but this association differed by age. Further studies are warranted to confirm its’ causal association and to understand the underlying mechanisms.