COVID-19 Pandemic and Sleep Disorders Among Pediatric and Adolescent Asthmatic Patients

Introduction/rationale: It is widely known that COVID-19 pandemic has had a harmful impact on different populations around the world. However, it is worth bearing in mind that asthma has influenced the world greater and is considered to be the most prevalent chronic illness in pediatric and adolescent patients. Moreover, the impact of COVID-19 on sleep disorders such as insomnia in this groups of patients has not been studied yet. Hence, the objective of this study is to investigate how COVID-19 pandemic affects sleep of pediatric and adolescent asthmatic patients in the Mediterranean area. Methods: This is a pilot prospective study. This study was conducted in accordance with the institutional review board with written informed consent and assent. The mandatory requirements were patients' age between 6 and 18 and the diagnosis of persistent asthma. Patients with asthma ± rhinitis/rhinoconjunctivitis could also be included. All participants in the study answered the BEARS Questionnaire (B=Bedtime Issues, E=Excessive Daytime Sleepiness, A=Night Awakenings, R=Regularity and Duration of Sleep, S=Snoring) and the Bruni Scale (SDSC, Sleep Disturbance Scale for Children). Results: 25 patients were included. The age group was between 10 and 18 years (14 ±4 ). Most of them were females (64%, n=16). Regarding the BEARS Questionnaire all patients had as minimum one positive response. Moreover, almost half of the patients had Bedtime Issues [BI;48% (n=12)] and/or Excessive Daytime Sleepiness [EDS;40% (n=10)]. As for the Bruni Questionnaire, most patients [18 out of 25 patients included (72%)] had high levels (more than 39 points in the Bruni Questionnaire) that indicated sleep disturbances among the population of the study. The most prevalent disorders found were for Sleeping Respiratory Disorders [SRD;13 of the 25 studied patients (52%)], for Sleeping Initiation and Maintenance Disorders [SIMD;40% (n=10)] and Excessive Daytime Sleepiness [also in 10 patients (40%)]. Conclusion: Increased levels of sleep disorders have been described in pediatric and adolescent asthmatic patients during COVID-19 pandemic. Sleep respiratory disorder is the most prevalent disorder in this groups of population. Therefore, it is preferable to provide patients with optimal respiratory diseases control in order to improve the quality of their sleep.