Sleep Quality in High School Students With Asthma

Sleep quality among adolescents is poor and asthma's impact is significant among adolescents.
Asthma control is an important risk factor for poor sleep and poor academic performance. In
addition, poor asthma control, poor sleep hygiene, and poor sleep quality are more likely in
urban settings. Interventions to promote sleep quality by targeting both asthma control and
sleep hygiene in this vulnerable population are lacking.

To adapt ASMA and Sleep-Smart, the investigators will use a 3-step iterative process that
will consist of (1) interviewing high school students and their caregivers, (2) interviewing
high school teachers and (3) conducting separate focus groups with students and caregivers.
The investigators hypothesize that the intervention will be feasible and acceptable. This
study is a multi-site trial and collaboration between Columbia University Medical Center and
Rhode Island Hospital (RIH).

ADOLESCENT-CAREGIVER DYADS (20 adolescents with persistent asthma and poor sleep, and their
caregivers - 10 in Step 1 and 10 in Step 3)

Inclusion Criteria:

1. a prior asthma diagnosis in the prior 12 months;

2. use of prescribed asthma medications;

3. persistent asthma (defined as (i) daytime symptoms 3+ days a week, (ii) night
awakenings 3+ nights per month, (iii) 2+ Emergency Department visits or (iv) 1+
hospitalization for asthma); and

4. sleep duration < 8 hours

Exclusion Criteria:

1. report of prior diagnosis of a sleep disorder, such as sleep disordered breathing,
restless leg syndrome, periodic limb movement syndrome;

2. A Pediatric Sleep Questionnaire (PSQ) score of 0.33 or more, a well-validated measure
of sleep disordered breathing risk;

3. active immunotherapy;

4. additional pulmonary disease; and

5. significant developmental delay and/or severe psychiatric or medical conditions that
preclude completion of study procedures or confound analyses.

SCHOOL TEACHERS (4 high school teachers - 2 from New York and 2 from Rhode Island in Step
2)

Inclusion Criteria:

- Teach at the high school level.

Exclusion Criteria:

- Unwilling to participate in the study.