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. 2023 Jan;34(1):e13909.
doi: 10.1111/pai.13909.

Dysfunctional breathing and its impact on asthma control in children and adolescents

Signe Vahlkvist  1 , Louise Jürgensen  1 , Tine Detlefsen Hell  2 , Thomas Houmann Petersen  1 , Poul-Erik Kofoed  1
Affiliations

Dysfunctional breathing and its impact on asthma control in children and adolescents

Signe Vahlkvist et al. Pediatr Allergy Immunol. 2023 Jan.

Abstract

Background: Dysfunctional breathing (DB) has been shown to negatively affect asthma control in adults, but for children and adolescents, the knowledge is scarce. DB is among others characterized by dyspnea and hyperventilation. The Nijmegen Questionnaire (NQ) is often used as a marker for DB. We conducted a cross-sectional survey to estimate the prevalence of DB in patients with asthma in a pediatric outpatient clinic and to determine the impact of DB on asthma control.

Methods: Patients between 10 and 17 years were invited to complete the NQ and the Asthma Control Questionnaire (ACQ) and report the use of beta2 agonist (β2). Spirometry data and prescribed asthma medications were noted from the patient record.

Results: Three hundred and sixty-three patients (180 boys) completed the survey. Sixty-seven patients (18%) scored ≥23 points in the NQ predicting DB. The DB group was older (median (range)) 15.6 (10.5-17.9) vs. 13.7 (10.0-17.9) years) (p < .01), and girls were overrepresented (84%) (p < .01). FEV1% exp. was higher in the DB group (mean (SD)) (89.4 (9.0) vs. 85.7 (11.8)) (p < .02). ACQ score (median (range)) (2.0 (0-4) vs. 0.6 (0-3.4)) (p < .01) and the use of β2 (median (range)) (2 (0-56) vs. 0 (0-20) puffs/week) (p < .01) were higher. Inhaled corticosteroid dose (mean (SD) (416 (160) vs. 420 (150) mcg) and the use of a second controller were equal between the groups.

Conclusion: Dysfunctional breathing was a frequent comorbidity, especially in adolescent girls. DB correlated with poorer asthma control and higher use of β2 and may be an important cofactor in difficult-to-treat asthma.

Keywords: adolescent; asthma; asthma control; child; dysfunctional breathing.

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Figures

FIGURE 1
FIGURE 1
ACQ correlated with both NQ and a modified NQ without three asthma overlap symptoms.
See this image and copyright information in PMC

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