0933 Asthma and Sleep-Related Environmental Factors Contributing to Sleep Awakenings in Urban Children with Asthma

Abstract Introduction Urban children with asthma encounter multiple asthma- and sleep-related environmental risks that can hinder asthma management and sleep. This study aimed to 1) describe the proportion of children exposed to asthma and sleep-related environmental factors that may challenge sleep and asthma outcomes, and 2) examine the association between night awakenings and asthma control using objective methods, including the role of asthma- and sleep-related environmental indicators in this association. Methods 150 urban children 7-9 years old with persistent asthma and their caregivers completed a 16-day observational protocol. Asthma control was assessed via the Asthma Control Test. Asthma and sleep outcomes were evaluated via self/caregiver report and objective (portable handheld spirometer, actigraphy) methods. Assessment of the asthma and sleep environment was also completed. Results Pets in the home were significantly associated with asthma control, and sharing a sleep surface was significantly associated with more sleep awakenings (p < 0.05). A higher proportion of children faced one asthma risk factor, whereas most children experienced four sleep environmental risks. Many participants also experienced 1–2 sleep hygiene challenges. The number of environmental exposures was similar between children with high versus low numbers of awakenings, and there were no significant associations between the total or indicator-specific number of exposures and asthma control or sleep awakenings. Conclusion Urban children experience multiple asthma- and sleep-related risks in their sleep environments, along with difficulties maintaining consistent sleep behaviors that support sleep onset and continuity. Although the quantity of exposures did not predict asthma control or awakenings in this sample, the type or quality of specific exposures may be more critical, particularly given heterogeneity in asthma and sleep vulnerability. Tailored, individualized approaches to asthma management, environmental control, and sleep hygiene may be necessary to improve both asthma and sleep outcomes for urban children with asthma. Support (if any) NHLBI R01HL142058 (Koinis Mitchell and Carskadon); NIGMS 5P20GM139743 (Carskadon)