Background: Environmental tobacco smoke (ETS) exposure and sleep associated problems can lead to serious health problems in children. We aimed to evaluate association between ETS and sleep disturbance in children. Methods: We enrolled 209 children without chronic health problems or acute infections aged 4 to 12 years between June 2019 and March 2020 to this cross-sectional study. Parents’ smoking habits and ETS exposure of children were questioned and Children’s Sleep Habits Questionnaire (CSHQ) was administered to screen for the most common sleep problems in children. “Sleep disturbance” was defined as a score ≥41 in CSHQ. Plasma cotinine levels were measured in all subjects enrolled and levels ≥ 3 ng/mL were defined as ETS exposure. Results: Total 115 children (55 %) were in the “sleep disturbance” group according to CSHQ, and 66 (57.3%) of them were exposed to ETS according to parental report. The children with parent reported ETS exposure had increased risk of sleep disturbance (adjusted OR: 1.3). All 209 children had plasma cotinine levels ≥3 ng/ml, with a mean (SD) 50.55 (13.78) ng/ml, revealing that all of them were exposed to ETS although only 105 of them were parent reported. Multivariable analysis of risk factors for sleep disturbance revealed that parent reported ETS exposure was associated with increased risks of sleep disturbance (p=0.023, adjusted OR: 1.9 and 95%CI: 1.09-3.3) Conclusions: Parent reported ETS exposure is associated with sleep disturbance in their children however parental reports about smoking habits may not be compatible with plasma cotinine levels of the children.

Background: Airway malacia is a condition of excessive airway collapsibility, which causes expiratory reduction in the cross-sectional luminal area during respiration. As this disorder may lead to life threatening events and even death in children, it is important to recognise and treat it. Aims: In this study, we aimed to evaluate clinical and radiological features, prognoses, and associated disorders of the patients with lower airway malacia. Methods: A total of 65 patients with lower airway malacia diagnosed by flexible bronchoscopy were included in this study. Demographic and clinical features, radiological findings, video image records of bronchoscopy and prognoses of the patients were evaluated retrospectively. Results: Lower airway malacia was diagnosed in 65 (16.6%) children with a median age of 1 year and 2 months (range: 1 month-16 years and 8 months). Thirty-five (53.8%) of them were male. The numbers of children with isolated tracheomalacia, isolated bronchomalacia and tracheobronchomalacia were nine (13.8%), 48 (73.8%) and eight (12.3%), respectively. The most common reason for admission was recurrent and/or prolonged respiratory infection (46.2%) and the most common physical examination finding was stridor (36.9%). Fifty-eight (89.2%) patients had other co-morbidities associated with airway malacia. Inhaled ipratropium bromide therapy was started for 37 (56.9%) patients. Ten (15.4%) patients required continuous positive pressure support.. Conclusion: Lower airway malacia is an important disorder in children with respiratory problems and flexible bronchoscopy is a valuable diagnostic method. Sharing experiences in terms of diagnosis and treatment modalities would help patients as well as clinicians.