氣喘兒童的睡眠問題

The Sleep Problems among Children with Asthma

氣喘是兒童常見的慢性疾病之一，氣喘兒童經常因為夜間咳嗽、喘鳴、以及呼吸困難而干擾他們的睡眠。夜發型氣喘常與許多睡眠問題相關，如入睡困難、睡眠不安、難以維持睡眠、日間嗜睡以及日間疲倦，氣喘不僅影響兒童也波及家長的睡眠狀況，更影響日間活動。氣喘病患需要知道夜發型氣喘意味著病情嚴重並增加死亡率。許多潛在的機轉可以解釋為何在夜間氣喘症狀容易惡化，如：日夜生理時鐘性（發炎過程、呼吸道阻塞、支氣管高度敏感性），以及非日夜生理時鐘性（如胃食道逆流）。護理人員應該了解氣喘夜間症狀的機轉，詳細評估睡眠狀況，以及提供適當的策略以改善氣喘兒童之睡眠品質。

Asthma is one of the most common chronic illnesses in children. Children with asthma often suffer from night coughing, wheezing and breathlessness that disturb their sleep. Nocturnal asthma is often associated with such problems as difficulty falling asleep, restless sleep, difficulty maintaining sleep, daytime sleepiness, and daytime tiredness. These sleep problems not only occur in children but also in their parents, and furthermore affect their daytime activity. People with asthma should be aware that nocturnal asthma is associated with more severe symptoms and increased mortality. Several underlying mechanisms that may shed light on how and why nighttime seems to exacerbate asthma symptoms include the inflammation process, airway resistance, and bronchial hyper-responsiveness (all circadian factors) as well as gastro-esophageal reflux (a non-circadian factor). Nurses should understand the mechanisms of nocturnal asthma and conduct sleep assessments comprehensively in order to design and implement appropriate strategies to improve the sleep quality of children with asthma.