Experimental methods to study sleep disruption and immune balance in urban children with asthma

Daphne Koinis-Mitchell; Gailen D Marshall; Sheryl J Kopel; Nicole M S Belanger; Jesús Ayala-Figueroa; Sofia Echevarria; Richard Millman; Tao Zheng; Jessica Weathers; Caroline A Gredvig; Mary A Carskadon

doi:10.1093/sleepadvances/zpac003

Experimental methods to study sleep disruption and immune balance in urban children with asthma

Sleep Adv. 2022 Jan 27;3(1):zpac003. doi: 10.1093/sleepadvances/zpac003. eCollection 2022.

Authors

Daphne Koinis-Mitchell^{1

2

3}, Gailen D Marshall⁴, Sheryl J Kopel^{1

2

3}, Nicole M S Belanger^{1

2

3}, Jesús Ayala-Figueroa^{1

2}, Sofia Echevarria^{1

2}, Richard Millman^{1

3}, Tao Zheng^{1

3}, Jessica Weathers⁵, Caroline A Gredvig⁵, Mary A Carskadon^{3

5}

Affiliations

¹ Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA.
² Bradley-Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA.
³ Warren Alpert Medical School of Brown University, Providence, RI, USA.
⁴ Division of Allergy, Asthma and Clinical Immunology, Department of Medicine, The University of Mississippi Medical Center, Jackson, Mississippi, USA.
⁵ EP Bradley Hospital Sleep and Chronobiology Research Laboratory, Providence, RI, USA.

Abstract

Study objectives: We describe research methods developed to examine effects of sleep disruption on changes in immune balance, lung function, and cognitive performance in a sample of urban, ethnically diverse children with persistent asthma. Two case examples (8- and 10-year-old males) are presented to highlight methods of the current study and illustrate effects of experimentally disrupted sleep on the immune balance profile (Th1/Th2 cytokines), key sleep variables from polysomnography data, and lung function in our sample.

Methods: Children follow an individualized structured sleep schedule consistent with their habitual sleep need (≥9.5 hours' time in bed) for six days before a laboratory-based experimental sleep protocol. Children then spend two successive nights in the sleep lab monitored by polysomnography: a baseline night consisting of uninterrupted sleep, and a disruption night, during which they are awoken for 2 minutes between 20-minute intervals of uninterrupted sleep. Evening and morning blood draws bracket baseline and disruption nights for immune biomarker assessment.

Results: A shift towards immune imbalance following the sleep disruption protocol was observed in these illustrative cases.

Conclusions: Data from these case examples provide evidence that the experimental protocol caused disruptions in sleep as observed on polysomnography and had the hypothesized downstream effects on immune balance associated with clinical asthma control. Documenting the effects of sleep disruption on immune function in children with persistent asthma is a crucial step towards understanding associations between sleep, immune balance, and asthma outcomes and provides important information for developing novel interventions for youth with asthma and suboptimal sleep.

Clinical trials: Not applicable.

Keywords: behavioral sleep medicine; biomarkers; child/children; immune function; pediatrics-behavior; pediatrics-pulmonary; pediatrics-sleep and arousal.

Abstract

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