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Feather bedding and childhood asthma associated with house dust mite sensitisation: a randomised controlled trial
  1. Nicholas J Glasgow1,
  2. Anne-Louise Ponsonby1,2,
  3. Andrew Kemp3,
  4. Euan Tovey4,
  5. Peter van Asperen3,5,
  6. Karen McKay3,5,
  7. Samantha Forbes5
  1. 1Medical School, The Australian National University, Acton, Australia
  2. 2Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
  3. 3Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, The Children's Hospital at Westmead Clinical School, Sydney, New South Wales, Australia
  4. 4Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
  5. 5Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
  1. Correspondence to Professor Nicholas J Glasgow, Building 42, The Australian National University, Acton, 0200 ACT, Australia; nicholas.glasgow{at}anu.edu.au

Abstract

Introduction Observational studies report inverse associations between the use of feather upper bedding (pillow and/or quilt) and asthma symptoms but there is no randomised controlled trial (RCT) evidence assessing the role of feather upper bedding as a secondary prevention measure.

Objective To determine whether, among children not using feather upper bedding, a new feather pillow and feather quilt reduces asthma severity among house dust mite (HDM) sensitised children with asthma over a 1-year period compared with standard dust mite avoidance advice, and giving children a new mite-occlusive mattress cover.

Design RCT.

Setting The Calvary Hospital in the Australian Capital Territory and the Children's Hospital at Westmead, Sydney, New South Wales.

Patients 197 children with HDM sensitisation and moderate to severe asthma.

Intervention New upper bedding duck feather pillow and quilt and a mite-occlusive mattress cover (feather) versus standard care and a mite-occlusive mattress cover (standard).

Main outcome measures The proportion of children reporting four or more episodes of wheeze in the past year; an episode of speech-limiting wheeze; or one or more episodes of sleep disturbance caused by wheezing; and spirometry with challenge testing. Statistical analysis included multiple logistic and linear regression.

Results No differences between groups were found for primary end points – frequent wheeze (OR 1.51, 95% CI 0.83 to 2.76, p=0.17), speech-limiting wheeze (OR 0.70, 95% CI 0.32 to 1.48, p=0.35), sleep disturbed because of wheezing (OR 1.17, 95% CI 0.64 to 2.13, p=0.61) or for any secondary end points. Secondary analyses indicated the intervention reduced the risk of sleep being disturbed because of wheezing and severe wheeze to a greater extent for children who slept supine.

Conclusion No differences in respiratory symptoms or lung function were observed 1 year after children with moderate–severe asthma and HDM sensitisation were given a mite-occlusive mattress cover and then received either feather upper bedding (pillow and quilt) or standard bedding care.

This paper is freely available online under the BMJ Journals unlocked scheme, see http://adc.bmj.com/info/unlocked.dtl

https://doi.org/10.1136/adc.2010.189696

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    Footnotes

    • Funding This study was funded by the National Health and Medical Research Council, Australia.

    • Competing interests None.

    • Ethics approval This study was conducted with the approval of the ACT Health Human Research Ethics Committee, the Sydney South West Area Health Service Human Research Ethics Committee and The Children's Hospital at Westmead Human Research Ethics Committee. The Australian Clinical Trial Registry Number was ACTRN12609000394246.

    • Provenance and peer review Not commissioned; externally peer reviewed.