FREQUENCY OF NOCTURNAL SYMPTOMS IN ASTHMATIC-CHILDREN ATTENDING A HOSPITAL OUTPATIENT-CLINIC

Since nocturnal symptoms indicate more severe asthma, we investigated their frequency in a hospital-based population of asthmatic children. Recognition of these symptoms offers the possibility to introduce appr opriate treatment. We studied 796 consecutive children with asthma (me an (SD) age 9 (4) yrs) attending a hospital clinic, to determine wheth er these nocturnal symptoms predicted that daytime activities would be affected, and also the patients' perception of disease severity. At t he end of a regular out-patient clinic visit, the answers to seven dif ferent questions concerning nocturnal symptoms in the previous 3 weeks were recorded. The forced expiratory volume in one second (FEV(1)) wa s greater than or equal to 90% predicted in 98% of the population that was able to perform lung function measurements (72% of the total popu lation). In 38% of the patients with nocturnal symptoms, these symptom s were reported spontaneously. When asked for, nocturnal symptoms were reported by 47% of the children; 6% every night and 34% at least once a week. Cough was the most frequently reported symptom (31%). Childre n with nocturnal symptoms had a lower FEV(1), scored their perception of asthma as more severe, and had their daytime activities affected mo re than those without nocturnal symptoms. Doctors should specifically ask about nocturnal symptoms, as not all patients with nocturnal sympt oms report them spontaneously and they predict more severe disease.