0938 Excessive Daytime Sleepiness and its Relationship to Sleep Disorders in Pediatric Patients with Asthma Using PSG Data

Abstract Introduction Excessive daytime sleepiness (EDS) is a common complaint in children with asthma. Several factors can contribute to EDS in asthmatic patients, including disrupted sleep from asthma, medications, and sleep disorders. Previous studies have shown complex relationships between asthma and OSA. However, there is limited information on other sleep disorders. Therefore, we aimed to assess underlying sleep disorders in pediatric asthma patients with EDS. Methods A retrospective study was performed in asthma patients aged 0-18 years old with EDS (ESS >10) who had PSG/MSLT at CCHMC. We calculated the percentage of OSA (oAHI> 1.5/hr), CSA (central apnea index> 5/hr), hypoventilation, PLMD (PLM index>5/hr), narcolepsy, and idiopathic hypersomnia(IH) for the whole population. For those with narcolepsy and IH, the percentage was calculated based on patients who underwent MSLT. In addition, comparison of percentage for each sleep diagnosis between children(≤ 12 yo) and adolescents (> 12 yo) was done by Chi-square or Fisher’s exact tests. Results 629 patients met the criteria for analysis. The mean age was 8.82±5.28 years, 59.3% male, 476 children, and 153 adolescents. There were no significant differences in the proportion of race and sex between children and adolescents. For the whole population, 53.6% were diagnosed with OSA, 3.6% with CSA, 4.29% with sleep-related hypoventilation, 19.7% with PLMD, 16.67% with narcolepsy, and 19.44% with IH. Comparison between children[C] and adolescent[A] demonstrated significant higher percentage of OSA(50.3%[C] vs 63.8%[A];P< 0.05) and lower percentage of CSA(4.96%[C] vs 0%[A];P< 0.05) in adolescents. There was a trend toward higher percentage of narcolepsy in adolescents (P=0.06). There were no significant differences in the percentage of hypoventilation, PLMD, or IH between children and adolescents. Conclusion Among pediatric asthma patients presenting with EDS, several sleep disorders were identified, with OSA being the most frequent diagnosis, followed by PLMD. Children and adolescents with asthma exhibited distinct profiles of sleep pathology with a higher prevalence of OSA in adolescents, but a higher prevalence of CSA in children. Interestingly, higher percentage of narcolepsy was identified in adolescents. These findings highlight the need for age-specific clinical screening strategies and support the role of PSG in evaluating asthmatic children with EDS. Support (if any) Cincinnati Children Research Foundation