Journal article
Multi-Level Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample
CHEST Pulmonary, Vol.1(3), 100019
12/2023
DOI: 10.1016/j.chpulm.2023.100019
PMCID: PMC10786403
PMID: 38222082
Abstract
Pediatric sleep-disordered breathing (SDB) disproportionately affects children with low socioeconomic status (SES). The multi-level risk factors that drive these associations are not well understood.
What are the associations between SDB risk factors, including individual health conditions (obesity, asthma, allergies), household SES (maternal education), indoor exposures (environmental tobacco smoke [ETS], pests), and neighborhood characteristics (neighborhood disadvantage [ND]), with pediatric SDB symptoms?
Cross-sectional analyses were performed on 303 children, 6-12 years, enrolled in the Environmental Assessment of Sleep Youth study from 2018-2022. Exposures were determined by caregiver reports, assays of measured settled dust from the child’s bedroom, and neighborhood-level census data (deriving the Childhood Opportunity Index to characterize ND). The primary outcome was the SDB-related symptom burden assessed by the OSA-18 questionnaire total score. Using linear regression models, we calculated associations between exposures and SDB-related symptom burden, adjusting for socio-demographic factors, then health conditions, indoor environment, and neighborhood factors.
The sample included 303 children (39%- Hispanic, Latino, Latina, or Spanish origin, 30%-Black or African American, 22% White, 11% Other). Increasing OSA-18 total scores were associated with low household SES after adjustment for demographic factors, and with asthma, allergies, ETS, pests (mouse, cockroach, and rodents), and an indoor environmental index (sum of the presence of pests and ETS; 0-2) after adjusting for socio-demographic factors. Even after further adjusting for asthma, allergies, and ND, ETS and pest exposure were associated (β; 95% CI) with OSA-18 (for ETS: 12.80; 7.07, 18.53, also adjusted for pest; pest exposure 3.69; 0.44, 6.94, also adjusted for ETS).
In addition to associations with ETS, a novel association was observed for indoor pest exposure and SDB symptom burden. Strategies to reduce household exposure to ETS and indoor allergens should be tested as approaches for reducing sleep health disparities.
Details
- Title: Subtitle
- Multi-Level Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample
- Creators
- Seyni Gueye-Ndiaye - Harvard Medical SchoolMarissa Hauptman - Harvard Medical SchoolXinting Yu - Harvard Medical SchoolLe Li - Harvard Medical SchoolMichael Rueschman - Harvard Medical SchoolCecilia Castro-Diehl - Harvard Medical SchoolTamar Sofer - Department of Statistics, Harvard T.H. Chan School of Public HealthJudith Owens - Harvard Medical SchoolDiane R. Gold - Harvard Medical SchoolGary Adamkiewicz - Department of Environmental Medicine, Harvard T.H. Chan School of Public HealthNervana Metwali - Department of Occupational and Environmental Health, University of Iowa College of Public HealthPeter S. Thorne - Department of Occupational and Environmental Health, University of Iowa College of Public HealthWanda Phipatanakul - Harvard Medical SchoolSusan Redline - Harvard Medical School
- Resource Type
- Journal article
- Publication Details
- CHEST Pulmonary, Vol.1(3), 100019
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.chpulm.2023.100019
- PMID
- 38222082
- PMCID
- PMC10786403
- ISSN
- 2949-7892
- Grant note
- DOI: 10.13039/100001465, name: American Thoracic Society; DOI: 10.13039/100000002, name: National Institutes of Health, award: L40HL165622, R01HL137192, R35HL135818, T32 HL007901; DOI: 10.13039/100000060, name: National Institute of Allergy and Infectious Diseases, award: K24AI106822; DOI: 10.13039/100000066, name: National Institute of Environmental Health Sciences, award: K23ES031663, P30ES000002, P30ES005605
- Language
- English
- Electronic publication date
- 09/2023
- Date published
- 12/2023
- Academic Unit
- Civil and Environmental Engineering; Occupational and Environmental Health
- Record Identifier
- 9984464475502771
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