This suggests the influence of circadian rhythms causing the nocturnal impairment of lung function ( 10). The three main features of asthma - airway obstruction, inflammation and bronchial hyper-responsiveness - are all linked to a circadian nadir at 4 am ( 8, 9). While everyone experiences a circadian-based nadir in lung function in the early morning, patients with NA experience a greater than normal diurnal decrease in airway function independent of sleep. NA has the characteristics of a circadian disorder, a sleep-related induction of asthma and a more severe form of asthma. In conclusion, this paper suggests that an automated wheeze detective device is an objective and practical tool to aid the diagnosis and monitoring of NA.Ī specific cause of NA has not yet been clearly defined. This review discusses the increasing prevalence of NA, current diagnostic tools and the consequences of undiagnosed NA in children. The presence of wheeze during sleep has been successfully employed as a tool to measure NA in children. The development of a non-invasive, objective, home-based diagnostic tool is crucial in diagnosing and monitoring children with NA. Therefore, NA is chronically underreported. In addition, there is the lack of physician familiarity regarding the assessment and treatment of NA. Children underreport and underestimate their NA symptoms and parents are not fully aware of their child’s NA indicators. As diurnal spirometry is not a practical tool for the diagnosis and monitoring of NA, self or parental reports are used. NA associated sleep disturbances and increased daytime sleepiness are especially important in children due to the accompanying behavioral and developmental difficulties. In addition to being associated with increased mortality, NA is associated with a decreased quality of life. Nocturnal asthma (NA) is increasing in prevalence, affecting millions of people worldwide.
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