Allergologia et Immunopathologia

Allergologia et Immunopathologia

Volume 48, Issue 2, March–April 2020, Pages 158-164
Allergologia et Immunopathologia

Original Article
Sleep disturbances and affecting factors in young children with food allergy and their mothers

https://doi.org/10.1016/j.aller.2019.06.014Get rights and content

Abstract

Objective

To examine sleep patterns and sleep disturbance of children with food allergy (FA) and their mothers.

Methods

The food allergy group included 71 children with mean age, 2.97 ± 1.52 years, and 58 control children were recruited the study. Mothers of children completed the Childhood Sleep Habits Questionnaire (CSHQ) and The Pittsburgh Sleep Quality Index (PSQI) in order to evaluate sleep disturbance in both children and themselves. Depressive symptomatology of mothers of children with or without food allergy was assessed with Beck-Depression Inventory II (BDI-II).

Results

The mean total scores of CSHQ was 49.33 ± 7.93 (range = 31–68) in the FA and 42.39 ± 6.43 (range = 30–62) in controls. The total CSHQ scores were significantly higher in children with FA than in controls (p = 0.002). The total PSQI score was significantly higher in mothers of children with FA than in mothers of children without FA (7.09 ± 3.11 vs 5.15 ± 2.59, p < 0.001) indicating that the mothers of children with FA had worse sleep quality. The mothers of children with FA had more depressive symptoms than mothers of children without FA. The mean total scores of BDI-II were 10.10 ± 6.95 in mothers of children with FA and 7.78 ± 6.64 in mothers of children without FA (p = 0.005).

Conclusion

The presence of a food allergy in a child may be associated with a deterioration in sleep quality in children and mothers as well as increased depressive symptoms in mothers.

Introduction

Food allergy (FA) is a growing public health problem throughout the world that affects the daily lives of children and their caregivers in varying degrees.1, 2 There are currently no cures available for patients with food allergy. Therapy is focused on food avoidance and emergency treatment of accidental food allergen ingestion.3

Sleep disorders are the most common behavioral problems in children. Sleep patterns change throughout life, although the quality and quantity of sleep always depend on individual factors such as age, sex, and psychological and environmental factors.4 Asthma and/or allergic rhinitis have been associated with sleep disturbances. Children with respiratory and atopic disease demonstrate poorer sleep than healthy children.5 Recent studies on the relationship between food allergies and sleep disorders have increased. Wang et al.6 reported a close relationship between food allergy and snoring in Chinese infants. A recent study reported that children with gastrointestinal (GI) food allergy were commonly associated with a wide range of extra-intestinal manifestations, such as poor sleep.7 In another study investigating sleep disorders in allergic and non-allergic children, eczema and food allergies were closely associated with sleep disorders.8

The presence of a child with food allergy in the family adversely affects the quality of life of the parents. As the number of children with allergies increases, quality of life is negatively affected both by the parent’s time for their own needs and in terms of family activities.9 When mothers and fathers were compared, mothers perceived their quality of life as worse and had higher anxiety levels.10

It is necessary to periodically evaluate children with food allergy and primary caregivers in terms of the need for psychosocial support. The purpose of this study was to compare sleep in young children with and without FA and their mothers. Additionally, the depressive symptomatology of the mothers was assessed. We hypothesized that compared with young children without FA, young children with FA would have poorer sleep patterns. We also aimed to investigate the sociodemographic and clinical correlated factors of sleep disturbances in these groups

Section snippets

Participants

Children between two and 10 years, followed up for FA for at least one month at the Pediatric Allergy and Gastroenterology Departments in our clinics, between June 2017 and February 2019 were enrolled. Diagnosis of FA was made for patients who fulfilled all of the following criteria: 1) food sIgE level ≥0.35 kU/L and/or a positive skin prick test with food (a wheal ≥3 mm compared with the negative control); 2) consistent and clear-cut history of the repeated symptoms associated with both

Sociodemographic data form

Characteristics of children (age, gender, comorbid medical disorder, duration of the food allergy, family history of atopy), sociodemographic characteristics of the family (family income, number of family members, education level of mother who the child was interviewed with) and existence of psychiatric disorder history in the family were assessed by a sociodemographic form that was developed by the authors.

Childhood sleep habits questionnaire (CSHQ)

The CSHQ11 is a retrospective, 45-item sleep-screening instrument designed for young

Sociodemographic characteristics of the participants

A total of 71 children with FA and 58 control children with a mean age of 3.34 ± 1.68 years were recruited to the study. There were no statistically significant differences between groups in term of the gender, age of the children, age of the mothers, number of children the family has, mental illness history in the family, family income and the education level of the mother (Table 1). The clinical and laboratory characteristics of the food allergy group are given in Table 2.

The CSHQ

Of the children with

Discussion

It has been reported that up to 40% of children experience sleep problems during childhood.18 When young children have sleep disruptions, parental sleep is also typically disrupted. Research has demonstrated that parents of children with chronic illnesses experience significant disruption to sleep and daytime functioning, resulting in increased maternal depressive symptoms.19, 20

Although the sample size was small, this is one of the first studies to examine sleep disorders both in children with

Conflict of interest

The authors have no conflict of interest to declare.

Acknowledgements

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. We thank Dr. Meral Bilgilisoy Filiz for assistance with statistical analysis.

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      Examination of the total mean scores obtained from the scale indicated that while mothers of children with no illness indicated that they had poor sleep quality according to the cutoff score of the scale, this score was found to be significantly lower in mothers of children with chronic illnesses. The same is applicable to the study conducted by Filiz et al. (2020). Yılmaz et al. (2008) indicated that mothers of children with cystic fibrosis and mothers of children with asthma had lower PSQI scores compared to mothers of children with no illnesses: however, the mean PSQI score of the three groups was less than 5 (Yılmaz et al., 2008).

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    The study protocol was approved by the Medical Ethics Committee of Antalya Training and Research Hospital.

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