Table 5.
The mediating effects of nighttime sleep qualitya and daytime sleepinessa on the association between asthma controla and asthma-specific HRQOLa using the multilevel path analyses+
| Parameter | 95% CI | ||||
|---|---|---|---|---|---|
| β | SE | Lower | Upper | ||
| Within level (within subject) | |||||
| Direct effect | |||||
| Asthma control -> Nighttime sleep quality | 0.35* | 0.04 | 0.28 | 0.42 | |
| Asthma control -> Daytime sleepiness | 0.09* | 0.03 | 0.04 | 0.14 | |
| Asthma control -> Asthma-specific HRQOL | 0.12* | 0.02 | 0.08 | 0.15 | |
| Nighttime sleep quality -> Daytime sleepiness | 0.09 | 0.05 | −0.00 | 0.19 | |
| Nighttime sleep quality -> Asthma-specific HRQOL | 0.03 | 0.03 | −0.01 | 0.08 | |
| Daytime sleepiness -> Asthma-specific HRQOL | 0.15* | 0.03 | 0.11 | 0.20 | |
| Indirect effect | |||||
| Asthma control -> Nighttime sleep quality -> Asthma-specific HRQOL | 0.01 | 0.01 | −0.01 | 0.03 | |
| Asthma control -> Daytime sleepiness -> Asthma-specific HRQOL | 0.01* | 0.01 | 0.00 | 0.02 | |
| Asthma control -> Nighttime sleep quality -> Daytime sleepiness -> Asthma-specific HRQOL | 0.01 | 0.00 | −0.00 | 0.01 | |
| Total indirect effect | 0.03* | 0.01 | 0.00 | 0.05 | |
| Between level (between subjects) | |||||
| Direct effect | |||||
| Asthma control -> Nighttime sleep quality | 1.04* | 0.21 | 0.69 | 1.39 | |
| Asthma control -> Daytime sleepiness | −0.37 | 0.43 | −1.08 | 0.34 | |
| Asthma control -> Asthma-specific HRQOL | 0.72* | 0.23 | 0.35 | 1.10 | |
| Nighttime sleep quality -> Daytime sleepiness | 0.69* | 0.24 | 0.31 | 1.08 | |
| Nighttime sleep quality -> Asthma-specific HRQOL | −0.26 | 0.14 | −0.53 | 0.02 | |
| Daytime sleepiness -> Asthma-specific HRQOL | 0.30* | 0.06 | 0.21 | 0.39 | |
| Indirect effect | |||||
| Asthma control -> Nighttime sleep quality -> Asthma-specific HRQOL | −0.27 | 0.18 | −0.61 | 0.02 | |
| Asthma control -> Daytime sleepiness -> Asthma-specific HRQOL | −0.11 | 0.14 | −0.38 | 0.14 | |
| Asthma control -> Nighttime sleep quality -> Daytime sleepiness -> Asthma-specific HRQOL | 0.22* | 0.11 | 0.06 | 0.44 | |
| Total indirect effect | −0.17 | 0.18 | −0.59 | 0.26 | |
Abbreviations: SE, standard error; CI, confidence interval; HRQOL, health-related quality of life.
Results were adjusted for the child’s age, gender, race/ethnicity, number of chronic conditions, and the parent’s age, education background, and marriage status.
Higher scores indicate worse asthma control, worse nighttime sleep quality, greater daytime sleepiness, and worse asthma-specific HRQOL.
p<0.05.