Asthma, Sleep Quality, and School Performance in Children

Asthma is a chronic lung disorder whereby the airway becomes narrowed or inflamed, making it difficult to breathe easily. A number or factors can trigger asthma symptoms including environmental factors such as pollen and cold air. Statistics Canada estimates that 13% of Canadian children aged 0 through 11 suffer from asthma.

One problem that has been linked to asthma in children is sleep disruption. Unfortunately asthma symptoms tend to spike at night, and with symptoms like wheezing, coughing and difficulty breathing, sleep loss is bound to happen.  New research from Brown University’s Alpert Medical School in Providence, Rhode Island delved a little further into this issue by analyzing the impact of asthma-related sleep loss on school performance. Principal investigator Daphne Koinis-Mitchell, PhD, Associate Professor of Psychiatry and Human Behavior (Research) and Associate Professor of Pediatrics (Research) explains, “While it has been recognized that missed sleep and school absences are important indicators of asthma morbidity in children, our study is the first to explore the associations between asthma, sleep quality, and academic performance in real time, prospectively, using both objective and subjective measures.”

The study examined data from 170 asthmatic children, aged 7 to 9. The following methods were used to obtain a complete picture of how asthma was affecting sleep and school performance.

  • Severity of the participants’ asthma symptoms were measured using spirometry–a pulmonary function test which tracks the speed and amount of air exhaled.
  • Sleep quality was measured by detecting body movements during the night.
  •  The children and their caregivers used diaries to report on their symptoms and how they attempted to control them.
  • The children’s teachers kept reports on the children’s behaviour and performance in school.

The study found that compared to children with well-controlled asthma, those with poorly-controlled asthma struggled more in school and showed carelessness with their school work. “Children can experience more symptoms at night because they are not taking their medications consistently,” said Koinis-Mitchell. “They end up missing sleep. When they wake, they are groggy, not alert and they attend school this way. That has an impact on their level of concentration. The quality of their work is compromised. In general, their academic function is negatively affected.”

Children under 12 should get 10-11 hours of sleep each night, while those in middle school and high school should aim for a solid nine hours. If you believe your child is struggling academically due to asthma-related sleep loss, talk to your doctor about the problem.  Controlling environmental factors and taking proper medication may help to alleviate your children’s asthma symptoms at night. A sleep specialist may also be able to provide advice on how to improve the sleep environment, to keep environmental triggers to a minimum.


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