An Unidentified Monster in the Bed – Assessing Nocturnal Asthma in Children

Nocturnal asthma (NA) is increasing in prevalence, affecting millions of people worldwide. In addition to being associated with increased mortality, NA is associated with a decreased quality of life. NA associated sleep disturbances and increased daytime sleepiness are especially important in children due to the accompanying behavioral and developmental difficulties. As diurnal spirometry is not a practical tool for the diagnosis and monitoring of NA, self or parental reports are used. Children underreport and underestimate their NA symptoms and parents are not fully aware of their child’s NA indicators. In addition, there is the lack of physician familiarity regarding the assessment and treatment of NA. Therefore, NA is chronically underreported. The development of a non-invasive, objective, home-based diagnostic tool is crucial in diagnosing and monitoring children with NA. The presence of wheeze during sleep has been successfully employed as a tool to measure NA in children. This review discusses the increasing prevalence of NA, current diagnostic tools and the consequences of undiagnosed NA in children. 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.