Aerosol therapy impractical in sleeping kids

By Will Boggs, MD

NEW YORK (Reuters Health) - Despite the advice of many pediatricians, giving young children aerosol therapy for asthma or wheezing while they are asleep is not feasible in most cases, Dutch researchers say.

Dr. Harm Tiddens, from Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues tested aerosol administration by means of an inhaler-spacer during sleep in 30 children with recurrent wheeze. The kids were 6 to 23 months of age.

The team found that 47 percent of the medication dose actually reached the children's lungs when they were treated while they were awake, but only 16 percent was delivered when administration was attempted while they slept.

More than two-thirds of the children woke up during the effort to administer aerosol during sleep, the researchers note in the medical journal Chest, and 75 percent of the children who awoke were distressed.

Three of seven children who showed poor cooperation during awake administration had higher sleep doses than awake doses, the report indicates, but these seven children slept through less than half the sleep administration attempts.

In order to improve the success rates of aerosol administration to young children, Tiddens recommends patience and a more playful approach rather than fighting with the child.

"We have many video recordings of these battles of the titans in the home situation," he said. "The child always wins."

SOURCE: Chest, August 2006.