A Study of Sleep Quality and Related Factors of Asthmatic Children

Asthma including frequently cough, wheeze, tachypnoea and dyspnea symptoms is a common chronic disease for children. Particularly at night or in early morning, it becomes worse and leads children waked accompanying the problem of sleep interruption. Therefore, this study was a cross-sectional survey research aimed to investigate sleep quality and related factors of asthma and non-asthma children by the instrument of a self-administered structural questionnaire and physiological monitors. 130 children (38 asthmatic children and 92 health children) in an elementary school and hospital in Taipei City were enrolled in the study by purposive sampling. The data were analyzed with descriptive and inference statistics by SPSS/Windows 12.0 software. The findings of study as follow:
1. In subjective sleep quality aspect, asthmatic children of subjective sleep quality score (11.26±6.51) worse than health children score (8.95±5.68). It means that asthmatic children of subjective sleep quality worse than health children.
2. In objective sleeping quality aspect, 10 school-age asthmatic children of total sleep time by actigraphy average 7.19~9.89 hours/day, night awakening time 32.07±19.18 minutes/day, sleep latency 7.76±5.86 minutes/day and sleep efficiency 95.92±2.74%; total sleep time by sleep diary average 7.22~10 hours/day, night awakening times 0.33±0.58 times/day, sleep latency 16.41±12.18minutes/day and sleep efficiency 95.32±2.97%.
3. The factors effected school-age children subjective sleep quality were asthma diagnosis, the grade, the severe level of asthma, life stress, sleep hygiene and nocturnal allergy symptoms. And the factors effected school-age children objective sleep quality were significant negative relationship between age and night awakening times( r=-0.67, p＜0.05). Besides, the objective sleep quality was significantly related to total sleep time, night awakening times and sleep latency.
4. There was a significant moderate positive relationship between life stress and subjective sleep quality; it means that more life stress children have worse subjective sleep quality, worse subjective self-sleep feeling and more severe sleep disturbance.
5. There was a significant negative relationship between sleep hygiene and subjective sleep quality( r=-0.23, p＜0.01). Besides, there were significant differences between school-age children of subjective sleep quality and “need of dolls, toys and blankets or not”, “be sounded by others or not”.
6. There was a significant positive relationship between nocturnal allergy symptoms and subjective sleep quality( r=0.34，p＜0.01); it means that children had more frequent nocturnal allergy symptoms have worse subjective sleep quality, worse subjective self-sleep feeling and more severe sleep disturbance.
7. Three independent variables of the second and sixth grade, life stress, nocturnal allergy symptoms were significant predicators of subjective sleep quality. The variables explained 36.9% of the variances in children’s subjective sleep quality.
According to the research findings, clinical nurses are highly recommended to pay more attention to asthmatic children of sleep assessment in the hospital and sleep condition at home. In order to control asthmatic condition, nurses are suggested to enhance asthma knowledge and home care efficacy of children with asthma and their family. In addition, nurses of out patient department, wards and schools should enhance family to regard for school-age child sleep quality, and help family with school-age child having good sleep hygiene. So, school-age children will have good sleep quality.