Effect of Night Symptoms and Disease Severity on Subjective Sleep Quality in Children With Non-Cystic-Fibrosis Bronchiectasis

Background: Night-time symptoms and hypoxemia during sleep may affect sleep quality in children with chronic lung disease such as bronchiectasis. Poor sleep quality may impair growth, learning, and emotional development of children. Our aim was to assess the sleep quality and associated factors in children with non-cystic fibrosis bronchiectasis. Methods: Fifty-four patients with bronchiectasis and age-matched controls were included to the study. Pittsburgh Sleep Quality Index (PSQI) and Pediatric Sleep Questionnaire (PSQ) were used to evaluate sleep quality and presence of sleep disordered breathing. A global sum of 5 or more according to PSQI indicated a poor sleep quality. A cut-off value of 0.33 in PSQ was used to identify pediatric sleep disordered breathing. Association between PSQI, pulmonary function tests, symptoms and HRCT scores were evaluated. Results: Thirty-seven percent of patients with bronchiectasis and 17% of patients in the control group had poor sleep quality (P < 0.05). Patients with sputum and wheezing had poorer sleep scores (P = 0.003 and P = 0.005). The association of wheezing and breathlessness during night time with sleep quality tended to be significant (P = 0.05). Twenty-two percent of patients with bronchiectasis and 9% of controls had sleep disordered breathing (P = 0.003). Bronchiectasis patients who snored had poorer sleep quality (P < 0.001) and patients with wheezing had significantly higher rate of snoring (P = 0.04). Children with worse HRCT scores also had worse sleep quality (r = 0.28, P = 0.04). Conclusions: Patients with bronchiectasis have disturbed sleep associated with severity of disease. Night symptoms increase the risk of poor sleep quality. Sleep disordered breathing and sleep quality should be assessed in these patients. Pediatr Pulmonol. 2011; 46:919-926. (C) 2011 Wiley-Liss, Inc.