Secondhand Smoke Associated With Childhood Sleep Problems

Wednesday, January 20, 2010

Children with asthma regularly exposed to secondhand smoke are more likely to have sleep problems, including difficulty falling asleep, more sleep-disordered breathing and increased daytime sleepiness, according to a new study in the February issue of Pediatrics.

“The consequences of inadequate sleep in children are not trivial,” says Kimberly Yolton, Ph.D., an environmental health researcher at Cincinnati Children’s and the study’s main author. “Sleep disturbances have been linked with increased behavior problems, mental health problems and poor school performance. A reduction in exposure to secondhand smoke has the potential to significantly impact the physical and emotional health of children with asthma.”

Dr. Yolton and her research colleagues examined 219 children enrolled in the Cincinnati Asthma Prevention Study. Participants were between the ages of six and 12, had physician-diagnosed asthma and had been treated for it within the previous year. Their parents reported that their children had been exposed to secondhand smoke at home from at least five cigarettes a day.

The researchers also measured serum cotinine -- a substance produced when the body breaks down nicotine. Cotinine provides a scientific assessment of tobacco exposure. By that measure, children in the study were exposed to a median of 13 cigarettes a day in their homes.

“As secondhand smoke exposure increased, parents reported longer delays in their children falling asleep; more frequent parasomnias, such as nightmares, night terrors and sleepwalking; more sleep disordered breathing; increased daytime sleepiness; and greater overall sleep disturbance,” says Dr. Yolton. “Ninety-three percent of those studied had a sleep disturbance score that would be considered clinically relevant, and the severity of the reported problems increased with greater exposure to tobacco smoke.”

Since all children in the study had asthma, the findings may not apply to children without asthma, according to Dr. Yolton.

The study was funded by grants from the National Institutes of Health.

About Cincinnati Children’s

Cincinnati Children’s Hospital Medical Center is one of 10 children’s hospitals in the United States to make the Honor Roll in U.S. News and World Reports 2009-10 America’s Best Children’s Hospitals issue. It is #1 ranked for digestive disorders and is also highly ranked for its expertise in respiratory diseases, cancer, neonatal care, heart care, neurosurgery, diabetes, orthopedics, kidney disorders and urology. One of the three largest children’s hospitals in the U.S., Cincinnati Children’s is affiliated with the University of Cincinnati College of Medicine and is one of the top two recipients of pediatric research grants from the National Institutes of Health.
President Barack Obama in June 2009 cited Cincinnati Children’s as an “island of excellence” in health care. For its achievements in transforming health care, Cincinnati Children’s is one of six U.S. hospitals since 2002 to be awarded the American Hospital Association-McKesson Quest for Quality Prize for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases. Additional information can be found at

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