Environmental tobacco smoke exposure disturbs sleep in children: a
cross-sectional study
Abstract
Background: Environmental tobacco smoke (ETS) exposure and sleep
associated problems can lead to serious health problems in children. We
aimed to evaluate association between ETS and sleep disturbance in
children. Methods: We enrolled 209 children without chronic health
problems or acute infections aged 4 to 12 years between June 2019 and
March 2020 to this cross-sectional study. Parents’ smoking habits and
ETS exposure of children were questioned and Children’s Sleep Habits
Questionnaire (CSHQ) was administered to screen for the most common
sleep problems in children. “Sleep disturbance” was defined as a score
≥41 in CSHQ. Plasma cotinine levels were measured in all subjects
enrolled and levels ≥ 3 ng/mL were defined as ETS exposure. Results:
Total 115 children (55 %) were in the “sleep disturbance” group
according to CSHQ, and 66 (57.3%) of them were exposed to ETS according
to parental report. The children with parent reported ETS exposure had
increased risk of sleep disturbance (adjusted OR: 1.3). All 209 children
had plasma cotinine levels ≥3 ng/ml, with a mean (SD) 50.55 (13.78)
ng/ml, revealing that all of them were exposed to ETS although only 105
of them were parent reported. Multivariable analysis of risk factors for
sleep disturbance revealed that parent reported ETS exposure was
associated with increased risks of sleep disturbance (p=0.023, adjusted
OR: 1.9 and 95%CI: 1.09-3.3) Conclusions: Parent reported ETS exposure
is associated with sleep disturbance in their children however parental
reports about smoking habits may not be compatible with plasma cotinine
levels of the children.