Although children with and without atopic dermatitis receive a comparable amount of sleep, children with the condition are more likely to have a reduced quality of sleep, regardless of the severity of disease.
“Pruritus, a hallmark of atopic dermatitis, is often worse at night, resulting in scratching that may interfere with the process of falling asleep and cause disruptions in ongoing sleep,” Faustine D. Ramirez, BA, from the University of California, San Francisco’s Program for Clinical Research in the department of dermatology, and colleagues wrote. “Adequate sleep is critical to well-being and health. In children, acute and chronic sleep disturbances have been associated with a wide range of cognitive, mood and behavioral impairments and have been linked to poor educational performance.”
The researchers examined data collected from almost 14,000 children who participated in the Avon Longitudinal Study of Parents and Children, a population-based birth cohort in Avon, United Kingdom. Of the children included in the study, 35.3% were defined as having atopic dermatitis. Sleep duration was assessed using standardized questionnaires at various time points between ages 2 and 16 years.
Children with active atopic dermatitis had similar sleep duration compared with children without the condition. The researchers found that children with atopic dermatitis lost only 2 minutes (95% CI, –4 to 0 minutes) of sleep daily compared with children without the condition.
However, children with active atopic dermatitis were almost 50% more likely to report reduced sleep quality (adjusted OR = 1.48; 95% CI, 1.33-1.66), and those with “quite bad” or “very bad” atopic dermatitis (aOR = 1.68; 95% CI, 1.42-1.98) plus asthma or allergic rhinitis (aOR = 1.79; 95% CI, 1.54-2.09) reported the worst sleep quality. Even children mild atopic dermatitis (aOR = 1.4; 95% CI, 1.27-1.54) or inactive atopic dermatitis (aOR = 1.41; 95% CI, 1.28-1.55) had statistically significantly increased odds of impaired sleep quality.
“From a clinical perspective, our findings suggest that pediatricians should consider screening all children with atopic dermatitis, even if their disease is mild or no longer active,” Ramirez and colleagues wrote. “Clinicians may offer anticipatory guidance, education, behavioral interventions and referrals if appropriate. Early detection and management of sleep problems in children with atopic dermatitis is critical to prevent quality-of-life impairments, daytime fatigue, as well as behavioral and mood disorders reported in children with atopic dermatitis.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.