Anxiety among adolescents with asthma: Relationships with asthma control and sleep quality.

Abstract

Objective: Adolescents with asthma are at increased risk for poor sleep quality, anxiety, and worse asthma control. Given associations between sleep and anxiety among youth and between asthma control and anxiety in the adult literature, this cross-sectional study aims to examine whether (1) asthma control and anxiety are related among adolescents with asthma and (2) sleep quality accounts for unique variance in symptoms of anxiety beyond asthma control. Methods: Forty-one adolescents with persistent asthma (Mage = 14.83, SD = 1.28) completed the Adolescent Sleep Wake Scale, the Multidimensional Anxiety Scale for Children 2, and the Asthma Control Test. Hierarchical linear regressions were conducted to assess whether sleep quality accounted for unique variance in anxiety above asthma control. Results: Asthma control was not related to overall anxiety, p > .05, but was associated with greater endorsement of Generalized Anxiety Disorder (GAD) and physical anxiety symptoms. Together, asthma control and sleep quality explained 32.3% of the variance in overall anxiety, F(3, 34) = 5.41, p = .004. Adding sleep quality to the model accounted for 15.8% of the variance, with worse sleep quality being associated with higher anxiety, β = −.43, p = .008. Controlling for asthma control, sleep quality also explained additional variance in GAD and physical anxiety symptoms. Asthma control and sleep quality were not related to harm avoidance, p > .05. Conclusions: Our results emphasize the importance of screening for anxiety and sleep difficulties when working with adolescents with asthma, particularly those with poor asthma control.

Subjective social status in adolescents with asthma: Psychosocial and physical health outcomes.

“…These clinics serve a racially and socioeconomically diverse catchment area in the southeastern United States and frequently serve children with publicly funded insurance (e.g., Medicaid). The current sample is representative of the demographic makeup of the surrounding communities and is consistent with the demographic makeup of our team’s previously published work (e.g., Fidler et al, 2019).…”

Assessment and management of anxiety and depression in a pediatric high‐risk asthma clinic

“…Lastly, it is well established that poor asthma control is associated with increased MH diagnosis 2,40,41 . Prior MH interventions in asthma have focused on improving medication adherence rather than addressing specific MH comorbidities 42 .…”

“…Psychiatric conditions, such as anxiety and depression, occur more frequently in children with asthma compared with healthy controls 1–3 and may have higher prevalence (58%) in the severe asthmatic pediatric population 4 . Children with asthma and comorbid anxiety and/or depression report more days with asthma symptoms, have increased emergency department utilization for asthma‐related symptoms, have higher hospitalization rates with longer hospital stays, and greater hospital expenses than their counterparts without these psychiatric comorbidities 5–7 .…”

“…Children with asthma and comorbid anxiety and/or depression report more days with asthma symptoms, have increased emergency department utilization for asthma‐related symptoms, have higher hospitalization rates with longer hospital stays, and greater hospital expenses than their counterparts without these psychiatric comorbidities 5–7 . Both anxiety and depression are associated with poor asthma control in adolescents, 2,8 and increasing asthma severity and poor control of asthma symptoms are associated with higher incidence of anxiety, depression, and ADHD 9…”

“…At this time, a separate MH screening protocol for the younger population is being established. Further exploration of MH morbidity and screening tools in the 4-12-year-old DTC asthma population remains an important area for further research.Lastly, it is well established that poor asthma control is associated with increased MH diagnosis 2,40,41. Prior MH interventions in asthma have focused on improving medication adherence rather than addressing specific MH comorbidities 42.…”