{'fraction_non_alphanumeric': 0.03178206583427923, 'fraction_numerical': 0.021566401816118047, 'mean_word_length': 5.229681978798586, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Low prevalence of obstructive sleep apnoea in paediatric severe therapy resistant asthma

Background: The reported prevalence of obstructive sleep apnoea (OSA) is 63% in children with “poorly controlled” asthma. Treatment of the OSA has been associated with improvement in their asthma control. All children referred to our service with problematic severe asthma (poor control despite GINA step 4/5 treatment) have a comprehensive assessment where modifiable factors such as poor adherence are addressed. Those with ongoing poor control despite attention to the basics of asthma management are defined as severe therapy resistant asthma (STRA). We hypothesised that the prevalence of OSA would be higher within this group than previous published unselected groups. Aim: (1) To establish the prevalence of OSA in children with STRA (2) To identify differences between STRA patients with and without OSA. Methods: All children defined as STRA at our centre from September 2013 to January 2018 underwent an in-lab sleep study. OSA was diagnosed based on the ERS taskforce definition. Results: 35 children underwent sleep studies (13 polysomnography; 22 cardiorespiratory polygraphy). 9 (25%) were prescribed maintenance oral prednisolone, 22 (63%) were prescribed montelukast and 11 (31%) nasal steroids. Only 3/35 STRA children had mild OSA (median obstructive AHI 2 events/hour, IQR 2-2.6). There were no differences in demographics, lung function or aeroallergen sensitisation between those with and without OSA. Discussion: The prevalence and severity of OSA in our cohort of STRA children was lower than published in unselected asthmatics. This may reflect their proven good adherence to high dose anti-inflammatory medication at the time of their sleep study.