Concordance Between Asthma Symptom Reports and Objective Lung Function, and Associations With Sleep Outcomes in Urban Children.

Objectives: To examine the extent to which asthma symptom concordance (ASC) or discordance (ASD) is associated with sleep outcomes in children with persistent asthma. Also, to investigate whether the association between ASC and sleep outcomes varies as a function of children's level of asthma control and severity.

Methods: A retrospective data analysis of Project NAPS (Nocturnal Asthma and Performance in School), an observational study which examined asthma and sleep outcomes in children with persistent asthma. Measures of ASC and ASD were developed from daily self-reported asthma symptoms and lung function measurements performed over 4 weeks. The extent to which ASC and ASD were associated with sleep efficiency, duration, and awakenings was evaluated. Concordance and discordance of asthma symptoms with sleep outcomes were examined as a function of the child's asthma severity and control.

Results: Those whose asthma symptom reports were in concordance with their lung function had longer sleep duration than children whose reports were discordant (difference = 15 min, Z = 2.61, p < 0.05), and more nighttime awakenings (difference = 0.6 awakenings, Z = 2.30, p < 0.05). Children with well-controlled asthma had longer sleep duration (difference = 18 min, p < 0.0001).

Conclusion: This study builds on the literature on asthma symptom recognition by adding an evaluation of how ASC relates to sleep outcomes. Findings suggest that concordance of asthma symptoms with lung function is associated with longer sleep duration and moderated by asthma control. ASC may be important to sleep duration, which has important implications for tailoring asthma management to optimize symptom concordance.