human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Habitual snoring , a prominent symptom of sleep-disordered breathing , is an important indicator for a number of health problems in children . Compared to adults , large epidemiological studies on childhood habitual snoring and associated predisposing factors are extremely scarce . The present study aim ed to assess the prevalence and associated factors of habitual snoring among Chinese school-aged children . Methods A r and om sample of 20,152 children aged 5.08 to 11.99 years old participated in a cross-sectional survey  , which was conducted in eight cities of China .  Parent-administrated question naires were used to collect information on children 's snoring frequency and the possible correlates . Results The prevalence of habitual snoring was 12.0 % ( 14.5 % for boys vs. 9.5 % for girls ) in our sample d children . Following factors were associated with an increased risk for habitual snoring : lower family income ( adjusted odds ratio [ OR ] = 1.46 ) , lower father 's education ( OR = 1.38 and 1.14 for middle school or under and high school of educational level , respectively ) , breastfeeding duration < 6 months ( OR = 1.17 ) , pregnancy maternal smoking ( OR = 1.51 ) , obesity ( OR = 1.50 ) , overweight ( OR = 1.35 ) , several respiratory problems associated with atopy and infection , such as chronic/allergic rhinitis ( OR = 1.94 ) , asthma ( OR = 1.43 ) , adenotonsillar hypertrophy ( OR = 2.17 ) , and chronic otitis media ( OR = 1.31 ) , and family history of habitual snoring ( OR = 1.70 ) . Conclusion The prevalence of habitual snoring in Chinese children was similar to that observed in other countries . The potential predisposing factors covered socioeconomic characteristics , environmental exposures , chronic health problems , and family susceptibility . Compared to socioeconomic status and family susceptibility , environmental exposures and chronic health problems had greater impact , indicating childhood habitual snoring could be partly prevented by health promotion and environmental intervention Background . Management of individual triggers is suboptimal in practice . In this project , we investigated the impact of symptom perception interventions on asthma trigger identification and self-reported asthma quality of life . Methods . Children with asthma ( n = 227 ) participated in three asthma education sessions and then were r and omized first to one of three home monitoring conditions ( symptom monitoring and peak flow training with feedback , peak flow training without feedback , or no peak flow training ) and then subsequently to one of three resistive load discrimination training conditions ( signal detection training with feedback , signal detection training without feedback , or no training ) . Triggers were reported at enrollment , following home monitoring , and following discrimination training ;  quality of life was measured after home monitoring and after resistive load testing . Results . Symptom perception interventions result ed in increases in reported triggers , which increased reliably as a function of home monitoring , and increased further in participants who completed discrimination training with feedback . Increases in the number of reported asthma triggers were associated with decreases in quality of life . Discussion . Patients may benefit from strategies that make trigger-symptom contingencies clear . Complementary strategies are needed to address changes in the perceived burden of asthma which comes from awareness of new asthma triggers INTRODUCTION Snoring and sleep-disordered breathing ( SDB )  are frequent pediatric conditions . Although allergies and respiratory viruses have been pathophysiologically implicated in these conditions , their seasonal distribution has not been examined . METHODS The records of all children participating in a prospect i ve , cross-sectional community-based research study that included a question naire on snoring frequency and loudness and an overnight sleep study were retrospectively assessed for seasonal patterns based on the day the children were evaluated . RESULTS A total of 1,051 children were included with a mean age of 7 years . There were no seasonal differences in the number of children evaluated or in their demographic characteristics . However , the odds of increased snoring frequency and loudness were significantly higher in spring and summer and lowest in fall ( P < 0.001 ) . However , the mean AHI was highest and the nadir SaO(2 ) was lowest in winter and spring compared to summer and fall ( P < 0.001 and P < 0.03 , respectively ) . CONCLUSION Snoring and the severity of SDB exhibit distinct and essentially non-overlapping patterns of seasonal variation , with peaks in spring-summer for snoring and peaks in winter-spring for SDB severity . These findings suggest that both seasonal viral and allergen burdens may contribute to SDB severity and may prompt differing clinical referral patterns throughout the year OBJECTIVE Respiratory health of Indigenous and minority ethnic groups in affluent countries is poorer than their non-minority counterparts and sleep disorders are no exception . In children , obstructive sleep apnoea has the potential to result in serious long-term consequences . In 1999 , we studied 1650 children and adolescents living in the Torres Strait and the Northern Peninsula Area , Australia . Here we report prevalence of snoring in these communities and relate its association with asthma symptoms . METHODS A population -based cross-sectional study was conducted in the Torres Strait region . Five indigenous communities were r and omly selected and information was collected using a structured face-to-face interview based on a st and ardized question naire . There was a 98 % response rate , and 1650 children , 0 - 17 years of age , were included in the study . RESULTS Overall , the prevalence of snoring was 14.2 % ( 95 % CI 12.5 - 15.9 ) ; 3.6 % ( 95 % CI 2.7 - 4.6 ) reported snorting , and 6 % ( 95 % CI 4.9 - 7.2 ) reported restless sleep . The prevalence of snoring was significantly higher among males ( 17.1 % for males and 10.8 for females , P = 0.005 ) . Children were five times more likely to have experienced snoring and snorting if they reported wheezing in the last 12 months . CONCLUSION We conclude that the prevalence of symptoms suggestive of obstructive sleep problems is relatively high in children of this region . This highlights the need for awareness among the community patients and physicians about the problem of obstructive sleep-disordered breathing , especially in children with asthma , and for the need for further studies to measure prevalence of sleep breathing disorders among Indigenous Australians STUDY OBJECTIVES Snoring during sleep is an important manifestation of obstructive sleep apnea syndrome ( OSAS ) . Although clinical history is not sufficiently sensitive and specific to distinguish primary snoring from OSAS , snoring is indicative of upper airway obstruction and may be associated with the presence of diurnal symptoms . Our study aims were to determine the prevalence of snoring in primary school children in Istanbul , and to evaluate the diurnal symptoms and conditions that may be associated with sleep problems . DESIGN , SETTING , AND SUBJECTS A parental question naire was used to assess the sleep and wake behavioral patterns in children . Eight representative schools in each of 9 school districts r and omly selected from the 32 school districts in Istanbul were visited . RESULTS The response rate was 78.1 % ; 2,147 of 2,746 question naires were fully completed , returned , and analyzed . The prevalence of habitual snoring was 7.0 % . Habitual snorers had significantly more nighttime symptoms , such as observed apneas ( odds ratio [ OR ] , 16.9 ; 95 % confidence interval [ CI ] , 10.0 to 28.8 ; p < 0.0001 ) , difficulty breathing ( OR , 17.8 ; CI , 10.9 to 29.2 ; p < 0.0001 ) , restless sleep , parasomnias , and nocturnal enuresis , compared to occasional and nonsnorers . There were also increased prevalence of daytime symptoms , such as falling asleep while watching television ( OR , 1.8 ; CI , 0.9 to 3.7 ; p = 0.01 ) and in public places ( OR , 2.1 ; CI , 1.2 to 3.8 ; p = 0.03 ) , and hyperactivity ( OR , 2.7 ; CI , 1.8 to 3.9 ; p < 0.0001 ) . Exposure to cigarette smoke and the presence of asthma and hay fever increased the likelihood of habitual snoring .  Children with a higher risk for OSAS ( habitual snoring , apnea , and difficulty breathing during sleep ) were also compared to nonsnorers . Although nighttime symptoms were more likely in the high-risk group , the risk of daytime symptoms increased as well . CONCLUSIONS Habitual snoring is a significant problem for children and may be associated with diurnal symptoms . Exposure to cigarette smoke at home and the presence of asthma and hay fever increase the likelihood of habitual snoring The aim of the study was to investigate whether wheezing is associated with disturbed sleep and increased daytime symptoms in school-aged children . A r and om sample of 1234 children , aged 6 - 14 years , participated in a respiratory health study in the region of Antwerp . The International Study of Asthma and Allergies in Childhood question naire and a separate sleep question naire were completed . In the children who wheezed in the last 12 months , sleep quality was more frequently disturbed due to nocturnal awakenings and restless sleep compared with children who did not wheeze . Daytime sleepiness and tiredness were more common in wheezing than in non-wheezing children . After adjusting for possible confounders a positive association was found between wheeze and : difficulties falling asleep [ odds ratio ( OR ) = 2.0 ] , restless sleep ( OR = 5.0 ) , daytime sleepiness ( OR = 3.8 ) and daytime tiredness ( OR = 5.1 ) . Chronic cough ( OR = 2.4 ) , snoring ( OR = 2.0 ) , chronic rhinitis ( OR = 2.6 ) and eczema ( OR = 3.3 ) were associated with disturbed sleep . Chronic cough ( OR = 2.5 ) and rhinitis ( OR = 4.1 ) were related to daytime tiredness . Chronic rhinitis was an important risk factor for snoring ( OR = 1.9 ) . In wheezing school-aged children , decreased quality of sleep and increased daytime tiredness and sleepiness were more often reported . Upper airway symptoms were related to the sleep disturbances INTRODUCTION The association between snoring , nocturnal cough , and allergic symptoms in young children is not known . OBJECTIVE To measure the prevalence of habitual snoring and its association with nocturnal cough , asthma , and hay fever in preschool children . SETTING A cross-sectional study . SUBJECTS Preschool children aged 2 to 5 years . METHOD The data were collected in a cross-sectional study . A total of 974 children were r and omly selected from two areas of Lismore and Wagga Wagga in New South Wales , Australia . RESULTS The prevalence of snoring was 10.5 % , with no gender difference ( p = 0.99 ) or trend association with age ( p = 0.58 ) . The association between snoring and nocturnal cough was highly significant ( odds ratio [ OR ] , 3.68 ; 95 % confidence interval [ CI ] , 2.41 to 5.63 ; p = 0.001 ) . This association was significant in both the nonasthmatic and asthmatic groups when examined separately . Snoring was also significantly associated with asthma ( OR , 2.03 ; 95 % CI , 1.34 to 3.10 ; p = 0.001 ) . In subjects without hay fever , the association between snoring and asthma was also highly significant ( 41.2 % vs 24.8 % ; OR , 2.12 ; 95 % CI , 1.34 to 3.37 ; p = 0.001 ) . CONCLUSION The prevalence of snoring in preschool children was 10.5 % for both genders . Snoring was significantly associated with both nocturnal cough and asthma . Because snoring , asthma , and nocturnal cough may have a common etiology , it is possible that effective treatment of one symptom may lead to reductions in the presence or severity of the other symptoms The prevalence and factors associated with snoring and habitual snoring in Asian children are largely unknown . Our objectives were to evaluate the prevalence and factors associated with snoring and habitual snoring in preschool and primary school children in Singapore . A self-response question naire on snoring was administered to parents of children aged 4 - 7 years in r and omly selected preschools and primary schools in Singapore . The overall response rate was 91.3 % ( nt = 11,114 ) . Snoring and habitual snoring were reported in 28.1 % and in 6.0 % of the children , respectively . On multivariate logistic regression analysis , snoring was significantly associated with male gender , race , atopy ( asthma , allergic rhinitis , or atopic dermatitis ) , maternal atopy ( allergic rhinitis or atopic dermatitis ) , maternal smoking , and breastfeeding . Habitual snoring was significantly associated with obesity ( odds ratio ( OR ) , 3.75 ; 95 % confidence interval ( CI ) , 1.67 - 8.42 ) , allergic rhinitis ( OR , 2.90 ; 95 % CI , 2.06 - 4.08 ) , atopic dermatitis ( OR , 1.80 ; 95 % CI , 1.28 - 2.54 ) , maternal smoking 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Habitual snoring , a prominent symptom of sleep-disordered breathing , is an important indicator for a number of health problems in children . Compared to adults , large epidemiological studies on childhood habitual snoring and associated predisposing factors are extremely scarce . The present study aim ed to assess the prevalence and associated factors of habitual snoring among Chinese school-aged children . Methods A r and om sample of 20,152 children aged 5.08 to 11.99 years old participated in a cross-sectional survey  , which was conducted in eight cities of China .  Parent-administrated question naires were used to collect information on children 's snoring frequency and the possible correlates . Results The prevalence of habitual snoring was 12.0 % ( 14.5 % for boys vs. 9.5 % for girls ) in our sample d children . Following factors were associated with an increased risk for habitual snoring : lower family income ( adjusted odds ratio [ OR ] = 1.46 ) , lower father 's education ( OR = 1.38 and 1.14 for middle school or under and high school of educational level , respectively ) , breastfeeding duration < 6 months ( OR = 1.17 ) , pregnancy maternal smoking ( OR = 1.51 ) , obesity ( OR = 1.50 ) , overweight ( OR = 1.35 ) , several respiratory problems associated with atopy and infection , such as chronic/allergic rhinitis ( OR = 1.94 ) , asthma ( OR = 1.43 ) , adenotonsillar hypertrophy ( OR = 2.17 ) , and chronic otitis media ( OR = 1.31 ) , and family history of habitual snoring ( OR = 1.70 ) . Conclusion The prevalence of habitual snoring in Chinese children was similar to that observed in other countries . The potential predisposing factors covered socioeconomic characteristics , environmental exposures , chronic health problems , and family susceptibility . Compared to socioeconomic status and family susceptibility , environmental exposures and chronic health problems had greater impact , indicating childhood habitual snoring could be partly prevented by health promotion and environmental intervention Background . Management of individual triggers is suboptimal in practice . In this project , we investigated the impact of symptom perception interventions on asthma trigger identification and self-reported asthma quality of life . Methods . Children with asthma ( n = 227 ) participated in three asthma education sessions and then were r and omized first to one of three home monitoring conditions ( symptom monitoring and peak flow training with feedback , peak flow training without feedback , or no peak flow training ) and then subsequently to one of three resistive load discrimination training conditions ( signal detection training with feedback , signal detection training without feedback , or no training ) . Triggers were reported at enrollment , following home monitoring , and following discrimination training ;  quality of life was measured after home monitoring and after resistive load testing . Results . Symptom perception interventions result ed in increases in reported triggers , which increased reliably as a function of home monitoring , and increased further in participants who completed discrimination training with feedback . Increases in the number of reported asthma triggers were associated with decreases in quality of life . Discussion . Patients may benefit from strategies that make trigger-symptom contingencies clear . Complementary strategies are needed to address changes in the perceived burden of asthma which comes from awareness of new asthma triggers INTRODUCTION Snoring and sleep-disordered breathing ( SDB )  are frequent pediatric conditions . Although allergies and respiratory viruses have been pathophysiologically implicated in these conditions , their seasonal distribution has not been examined . METHODS The records of all children participating in a prospect i ve , cross-sectional community-based research study that included a question naire on snoring frequency and loudness and an overnight sleep study were retrospectively assessed for seasonal patterns based on the day the children were evaluated . RESULTS A total of 1,051 children were included with a mean age of 7 years . There were no seasonal differences in the number of children evaluated or in their demographic characteristics . However , the odds of increased snoring frequency and loudness were significantly higher in spring and summer and lowest in fall ( P < 0.001 ) . However , the mean AHI was highest and the nadir SaO(2 ) was lowest in winter and spring compared to summer and fall ( P < 0.001 and P < 0.03 , respectively ) . CONCLUSION Snoring and the severity of SDB exhibit distinct and essentially non-overlapping patterns of seasonal variation , with peaks in spring-summer for snoring and peaks in winter-spring for SDB severity . These findings suggest that both seasonal viral and allergen burdens may contribute to SDB severity and may prompt differing clinical referral patterns throughout the year OBJECTIVE Respiratory health of Indigenous and minority ethnic groups in affluent countries is poorer than their non-minority counterparts and sleep disorders are no exception . In children , obstructive sleep apnoea has the potential to result in serious long-term consequences . In 1999 , we studied 1650 children and adolescents living in the Torres Strait and the Northern Peninsula Area , Australia . Here we report prevalence of snoring in these communities and relate its association with asthma symptoms . METHODS A population -based cross-sectional study was conducted in the Torres Strait region . Five indigenous communities were r and omly selected and information was collected using a structured face-to-face interview based on a st and ardized question naire . There was a 98 % response rate , and 1650 children , 0 - 17 years of age , were included in the study . RESULTS Overall , the prevalence of snoring was 14.2 % ( 95 % CI 12.5 - 15.9 ) ; 3.6 % ( 95 % CI 2.7 - 4.6 ) reported snorting , and 6 % ( 95 % CI 4.9 - 7.2 ) reported restless sleep . The prevalence of snoring was significantly higher among males ( 17.1 % for males and 10.8 for females , P = 0.005 ) . Children were five times more likely to have experienced snoring and snorting if they reported wheezing in the last 12 months . CONCLUSION We conclude that the prevalence of symptoms suggestive of obstructive sleep problems is relatively high in children of this region . This highlights the need for awareness among the community patients and physicians about the problem of obstructive sleep-disordered breathing , especially in children with asthma , and for the need for further studies to measure prevalence of sleep breathing disorders among Indigenous Australians STUDY OBJECTIVES Snoring during sleep is an important manifestation of obstructive sleep apnea syndrome ( OSAS ) . Although clinical history is not sufficiently sensitive and specific to distinguish primary snoring from OSAS , snoring is indicative of upper airway obstruction and may be associated with the presence of diurnal symptoms . Our study aims were to determine the prevalence of snoring in primary school children in Istanbul , and to evaluate the diurnal symptoms and conditions that may be associated with sleep problems . DESIGN , SETTING , AND SUBJECTS A parental question naire was used to assess the sleep and wake behavioral patterns in children . Eight representative schools in each of 9 school districts r and omly selected from the 32 school districts in Istanbul were visited . RESULTS The response rate was 78.1 % ; 2,147 of 2,746 question naires were fully completed , returned , and analyzed . The prevalence of habitual snoring was 7.0 % . Habitual snorers had significantly more nighttime symptoms , such as observed apneas ( odds ratio [ OR ] , 16.9 ; 95 % confidence interval [ CI ] , 10.0 to 28.8 ; p < 0.0001 ) , difficulty breathing ( OR , 17.8 ; CI , 10.9 to 29.2 ; p < 0.0001 ) , restless sleep , parasomnias , and nocturnal enuresis , compared to occasional and nonsnorers . There were also increased prevalence of daytime symptoms , such as falling asleep while watching television ( OR , 1.8 ; CI , 0.9 to 3.7 ; p = 0.01 ) and in public places ( OR , 2.1 ; CI , 1.2 to 3.8 ; p = 0.03 ) , and hyperactivity ( OR , 2.7 ; CI , 1.8 to 3.9 ; p < 0.0001 ) . Exposure to cigarette smoke and the presence of asthma and hay fever increased the likelihood of habitual snoring .  Children with a higher risk for OSAS ( habitual snoring , apnea , and difficulty breathing during sleep ) were also compared to nonsnorers . Although nighttime symptoms were more likely in the high-risk group , the risk of daytime symptoms increased as well . CONCLUSIONS Habitual snoring is a significant problem for children and may be associated with diurnal symptoms . Exposure to cigarette smoke at home and the presence of asthma and hay fever increase the likelihood of habitual snoring The aim of the study was to investigate whether wheezing is associated with disturbed sleep and increased daytime symptoms in school-aged children . A r and om sample of 1234 children , aged 6 - 14 years , participated in a respiratory health study in the region of Antwerp . The International Study of Asthma and Allergies in Childhood question naire and a separate sleep question naire were completed . In the children who wheezed in the last 12 months , sleep quality was more frequently disturbed due to nocturnal awakenings and restless sleep compared with children who did not wheeze . Daytime sleepiness and tiredness were more common in wheezing than in non-wheezing children . After adjusting for possible confounders a positive association was found between wheeze and : difficulties falling asleep [ odds ratio ( OR ) = 2.0 ] , restless sleep ( OR = 5.0 ) , daytime sleepiness ( OR = 3.8 ) and daytime tiredness ( OR = 5.1 ) . Chronic cough ( OR = 2.4 ) , snoring ( OR = 2.0 ) , chronic rhinitis ( OR = 2.6 ) and eczema ( OR = 3.3 ) were associated with disturbed sleep . Chronic cough ( OR = 2.5 ) and rhinitis ( OR = 4.1 ) were related to daytime tiredness . Chronic rhinitis was an important risk factor for snoring ( OR = 1.9 ) . In wheezing school-aged children , decreased quality of sleep and increased daytime tiredness and sleepiness were more often reported . Upper airway symptoms were related to the sleep disturbances INTRODUCTION The association between snoring , nocturnal cough , and allergic symptoms in young children is not known . OBJECTIVE To measure the prevalence of habitual snoring and its association with nocturnal cough , asthma , and hay fever in preschool children . SETTING A cross-sectional study . SUBJECTS Preschool children aged 2 to 5 years . METHOD The data were collected in a cross-sectional study . A total of 974 children were r and omly selected from two areas of Lismore and Wagga Wagga in New South Wales , Australia . RESULTS The prevalence of snoring was 10.5 % , with no gender difference ( p = 0.99 ) or trend association with age ( p = 0.58 ) . The association between snoring and nocturnal cough was highly significant ( odds ratio [ OR ] , 3.68 ; 95 % confidence interval [ CI ] , 2.41 to 5.63 ; p = 0.001 ) . This association was significant in both the nonasthmatic and asthmatic groups when examined separately . Snoring was also significantly associated with asthma ( OR , 2.03 ; 95 % CI , 1.34 to 3.10 ; p = 0.001 ) . In subjects without hay fever , the association between snoring and asthma was also highly significant ( 41.2 % vs 24.8 % ; OR , 2.12 ; 95 % CI , 1.34 to 3.37 ; p = 0.001 ) . CONCLUSION The prevalence of snoring in preschool children was 10.5 % for both genders . Snoring was significantly associated with both nocturnal cough and asthma . Because snoring , asthma , and nocturnal cough may have a common etiology , it is possible that effective treatment of one symptom may lead to reductions in the presence or severity of the other symptoms The prevalence and factors associated with snoring and habitual snoring in Asian children are largely unknown . Our objectives were to evaluate the prevalence and factors associated with snoring and habitual snoring in preschool and primary school children in Singapore . A self-response question naire on snoring was administered to parents of children aged 4 - 7 years in r and omly selected preschools and primary schools in Singapore . The overall response rate was 91.3 % ( nt = 11,114 ) . Snoring and habitual snoring were reported in 28.1 % and in 6.0 % of the children , respectively . On multivariate logistic regression analysis , snoring was significantly associated with male gender , race , atopy ( asthma , allergic rhinitis , or atopic dermatitis ) , maternal atopy ( allergic rhinitis or atopic dermatitis ) , maternal smoking , and breastfeeding . Habitual snoring was significantly associated with obesity ( odds ratio ( OR ) , 3.75 ; 95 % confidence interval ( CI ) , 1.67 - 8.42 ) , allergic rhinitis ( OR , 2.90 ; 95 % CI , 2.06 - 4.08 ) , atopic dermatitis ( OR , 1.80 ; 95 % CI , 1.28 - 2.54 ) , maternal smoking 
    Output:
    