Wheeze sound characteristics are associated with nighttime sleep disturbances in younger children

Chizu Habukawa; Naoto Ohgami; Naoki Matsumoto; Kenji Hashino; Kei Asai; Tetsuya Sato; Katsumi Murakami

doi:10.5415/apallergy.2020.10.e26

Wheeze sound characteristics are associated with nighttime sleep disturbances in younger children

Asia Pac Allergy. 2020 Jul 13;10(3):e26. doi: 10.5415/apallergy.2020.10.e26. eCollection 2020 Jul.

Authors

Chizu Habukawa¹, Naoto Ohgami², Naoki Matsumoto², Kenji Hashino², Kei Asai², Tetsuya Sato², Katsumi Murakami³

Affiliations

¹ Department of Pediatrics, Minami Wakayama Medical Center, Tanabe, Japan.
² Technology Development HQ, Omron Healthcare Co., Ltd., Muko, Japan.
³ Department of Psychosomatic Medicine, Sakai Sakibana Hospital, Sakai, Japan.

Abstract

Background: Wheezing is a typical symptom of respiratory conditions. Few objective methods are available for predicting sleep disturbance in young children with wheezing.

Objective: We investigated whether wheezing characteristics, detected by lung-sound analysis, were associated with risk of sleep disturbance.

Methods: We recorded the lung sounds of 66 young children (4-59 months) every morning, for the entire duration of a wheezing episode. On lung-sound analysis, wheezing was displayed as horizontal bars of intensity with corresponding sharp peaks of power. The sharp peak of power was defined as a wheeze band. Wheezing characteristics (e.g., number, frequency, duration, and frequency of maximum intensity of wheeze bands) were analyzed using lung-sound analysis. Patients were divided into 3 groups based on sleep disturbance on the first night after wheezing was recorded: mild group (no sleep disturbance and disappearance of wheezing within 2 days), moderate group (no sleep disturbance but disappearance of wheezing after 3 or more days), and severe group (sleep disturbance and disappearance of wheezing after 3 or more days). Wheezing characteristics on the first morning were compared among the 3 groups based on sleep disturbance on the first night.

Results: The highest frequency, the frequency of maximum intensity, and the number of wheeze bands per 30 seconds were significantly higher in the severe group than in the mild group (p < 0.005, p < 0.005, p < 0.001, respectively). The number of wheeze bands per 30 seconds was a predictor of nighttime sleep disturbance, with a cutoff value of 11.1. The sensitivity, specificity, and positive- and negative-predictive values were 100%, 65%, 32%, and 100% (p < 0.001), respectively, with an area under the curve of 0.86 ± 0.05.

Conclusions: The number of wheeze bands per 30 seconds on lung-sound analysis was a useful indicator of risk of prolonged exacerbation.

Keywords: Exacerbation; Lung-sound analysis; Sleep disturbance; Wheeze; Young children.