Ayşe SÜLEYMAN, Esra ÖZEK, Zeynep HIZLI DEMİRKALE, Sevgi SİPAHİ ÇİMEN, Cevdet ÖZDEMİR, Zeynep Ülker TAMAY, Nermin GÜLER

OKUL ÖNCESİ ASTIMLI ÇOCUKLARDA YATMADAN ÖNCEKİ BESLENME: ÜST SOLUNUM YOLU SEMPTOMLARINI VE ASTIM KONTROLÜNÜ ETKİLER Mİ?

Amaç: Bu çalışmada amacımız okul öncesi astımlı çocuklarda yatmadan önceki son beslenme saati, uykuda beslenmeleri, gece yatma saati, sabah kalkma saati ve sosyal çevresi ile ilgili faktörlerin üst solunum yolu semptomları ve astım kontrolü üzerine etkilerini araştırmaktadır. Gereç ve Yöntem: Çalışma, okul öncesi astımlı çocuklar ile benzer cinsiyet, yaş dağılımına sahip sağlıklı çocuklarda yapıldı. Bulgular: Çalışma gurubuna 103’ü (%47,5) astım, 114’ü (%52,5) sağlıklı olmak üzere 217 çocuk alındı. Gece yatmadan önce son 2 saat içinde beslenme sıklığı astımlı çocuklarda %47,6 iken sağlıklı çocuklarda %82,5 idi (p<0,001). Astımlı çocuklarda yatmadan 0-2 saat içinde beslenme ile ses kısıklığı (r=0,429, p=0,001), horlama (r=0,430, p=0,001), burun akıntısı (r=0,429, p=0,001) ve burun tıkanıklığı (r=0,469, p=0,001) arasında pozitif yönde korelasyon vardı. Sağlıklı çocuklarda ise yatmadan 0-2 saat arasında beslenme ile horlama (r=0,227, p=0,016) ve otit sayısı (r=0,294, p=0,002) pozitif yönde korelasyon vardı. Kontrolsüz astım için risk faktörleri çocuğa anne dışında birinin bakması, çocuğun sabah geç uyanması ve gece uyanma sıklığı idi. Sonuç: Okul öncesi astımlı çocuklarda yatmadan 0-2 saat içinde beslenme üst solunum yolu semptomalarında artışa neden olabileceğinden kaçınılmalıdır.

Anahtar Kelimeler:

Astım, okul öncesi çocuk, uyku

FEEDING BEFORE BEDTIME IN PRESCHOOL CHILDREN WITH ASTHMA: DOES IT AFFECT UPPER RESPIRATORY SYMPTOMS AND ASTHMA CONTROL?

Objective: In this study, our aim was to investigate the effects of feeding habits such as the last feed before bedtime, feeding during sleep, bedtime, waking time and factors associated with the social environment on upper airway tract symptoms and asthma control. Material and Method: The study was conducted on children with preschool asthma and their age and sex matched healthy children. Results: The study group included 217 children, 103 of whom have asthma and 114 were (52.5%) healthy. The frequency of feeding in the last 2 hours before going to bed was 47.6% in children with asthma and 82.5% in healthy children (p<0.001). In children with asthma, there was a positive correlation between feeding within 0-2 hours before going to bed and hoarseness (r=0.429, p=0.001), snoring (r=0.430, p=0.001), rhinorrhea (r=0.429, p=0.001) and nasal congestion (r=0.469, p=0.001). In healthy children, the same positive correlation was detected with snoring (r=0.227, p=0.016) and the number of otitis (r=0.294, p=0.002). Caregivers other than mothers, the late awakening and the number of wake-ups during night were determined as risk factors for uncontrolled asthma. Conclusion: Not feeding in 0-2 hours before bedtime seems to be advisable for asthmatic preschool children since it can cause an increase in upper respiratory symptoms.

Keywords:

Asthma, preschool children, sleep,

PDF

___

1. Truong KK, Lam MT, Grandner MA, Sassoon CS, Malhotra A. Timing matters: Circadian rhythm in sepsis, obstructive lung disease, obstructive sleep apnea, and cancer. Ann Am Thorac Soc 2016;13(7):1144-54. [CrossRef]
2. de Benedictis FM, Bush A. Respiratory manifestations of gastro-oesophageal reflux in children. Arch Dis Child 2018;103(3):292-6. [CrossRef]
3. Mindell JA, Williamson AA. Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Med Rev 2018;40:93-108. [CrossRef]
4. Leung AK, Hon KL. Gastroesophageal reflux in children: an updated review. Drugs Context 2019;17(8):212591. [CrossRef]
5. Global initiative for Asthma, Global strategy for asthma management and prevention. 2019 Available from: www. ginasthma.org Erişim tarihi: 02.03.2020.
6. Nakao A. Clockwork allergy: How the circadian clock underpins allergic reactions. J Allergy Clin Immunol 2018;142(4):1021-31. [CrossRef]
7. Hess JM, Jonnalagadda SS, Slavin JL. What Is a snack, why do we snack, and how can we choose better snacks? A Review of the definitions of snacking, motivations to snack, contributions to dietary intake, and recommendations for improvement. Adv Nutr 2016;7(3):466-75. [CrossRef]
8. McDonald L, Wardle J, Llewellyn CH, Johnson L, van Jaarsveld CH, Syrad H et al. Sleep and nighttime energy consumption in early childhood: A population-based cohort study. Pediatr Obes 2015;10(6):454-60. [CrossRef]
9. VanItallie TB. Sleep and energy balance: İnteractive homeostatic systems. Metabolism 2006;55(10 Suppl 2):S30- 5. [CrossRef]
10. Nicolaidis S. Metabolic mechanism of wakefulness (and hunger) and sleep (and satiety): role of adenosine triphosphate and hypocretin and other peptides. Metabolism 2006;55(10 Suppl 2): S24-9. [CrossRef]
11. Paganelli R, Petrarca C, Di Gioacchino M. Biological clocks: Their relevance to immune-allergic diseases. Clin Mol Allergy 2018;16:1. [CrossRef]
12. Burioka N, Fukuoka Y, Takata M, Endo M, Miyata M, Chikumi H, et al. Circadian rhythms in the CNS and peripheral clock disorders: function of clock genes: influence of medication for bronchial asthma on circadian gene. J Pharmacol Sci 2007;103(2):144-9. [CrossRef]
13. Lamia KA, Papp SJ, Yu RT, Barish GD, Uhlenhaut NH, Jonker JW, et al. Cryptochromes mediate rhythmic repression of the glucocorticoid receptor. Nature 2011;480(7378):552-6. [CrossRef]
14. Krakowiak K, Durrington HJ. The role of the body clock in asthma and COPD: Implication for treatment. Pulm Ther 2018;4(1):29-43. [CrossRef]
15. Paiva Ferreira LKD, Paiva Ferreira LAM, Monteiro TM, Bezerra GC, Bernardo LR, Piuvezam MR. Combined allergic rhinitis and asthma syndrome (CARAS). Int Immunopharmacol 2019;74:105718. [CrossRef]
17. Rosen R, Vandenplas Y, Singendonk M, Cabana M, DiLorenzo C, Gottrand F, et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 2018;66(3):516-54. [CrossRef]
18. Poddar U. Gastroesophageal reflux disease (GERD) in children. Paediatr Int Child Health 2019;39(1):7-12. [CrossRef]
19. Cooper PJ, Rodrigues LC, Barreto ML. Influence of poverty and infection on asthma in Latin America. Curr Opin Allergy Clin Immunol 2012;12(2):171-8. [CrossRef]
20. Ball TM, Castro-Rodriguez JA, Griffith KA, Holberg CJ, Martinez FD, Wright AL. Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med 2000;343(8):538-43. [CrossRef]
21. van Meel ER, den Dekker HT, Elbert NJ, Jansen PW, Moll HA, Reiss IK, et al. A population-based prospective cohort study examining the influence of early-life respiratory tract infections on school-age lung function and asthma. Thorax 2018;73(2):167-73. [CrossRef]
22. Azad MB, Vehling L, Lu Z, Dai D, Subbarao P, Becker AB et al. CHILD Study Investigators. Breastfeeding, maternal asthma and wheezing in the first year of life: A longitudinal birth cohort study. Eur Respir J 2017;49(5):1602019. [CrossRef]