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Sleep fragmentation in children with atopic dermatitis
1Pediatric Dermatology Clinic, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Children with atopic dermatitis (AD) in remission experience more sleep disturbances than healthy children. These disruptions are not primarily caused by scratching, indicating other underlying factors affecting sleep quality in pediatric AD.
Area of Science:
- Pediatric Dermatology
- Sleep Medicine
- Clinical Psychology
Background:
- Atopic dermatitis (AD) is a common chronic inflammatory skin disease in children.
- Sleep disturbances are frequently reported in children with AD, but the underlying mechanisms remain unclear.
- Understanding sleep patterns in children with AD during remission is crucial for effective management.
Purpose of the Study:
- To investigate and characterize the sleep patterns of children diagnosed with atopic dermatitis (AD) who are in a state of clinical remission.
- To compare the sleep parameters of children with remitted AD to those of a healthy control group.
Main Methods:
- Polysomnography, including scratch electrodes and video monitoring, was used to assess sleep in 14 children with AD (mean age 6 years) and 9 healthy controls (mean age 7 years).
- Parent-reported questionnaires were also utilized to gather subjective sleep data.
- Children with AD were studied during periods of clinical remission, with no other concurrent medical or psychiatric conditions.
Main Results:
- While sleep latency, total sleep time, and sleep efficiency were comparable between groups, children with AD exhibited significantly more arousals and awakenings per hour (24.1 vs. 15.4).
- Scratching events accounted for only 15% of these sleep disruptions.
- The majority of arousals and awakenings in the AD group were not associated with identifiable polysomnographic events like apnea or limb movements.
Conclusions:
- Children with atopic dermatitis in clinical remission experience significant sleep disturbances.
- These sleep disturbances are not solely attributable to scratching, suggesting other factors contribute to impaired sleep quality in pediatric AD.
Objective:
To characterize the sleep pattern of children with atopic dermatitis in clinical remission.
Methods:
Fourteen children with atopic dermatitis, with a mean+/-SD age of 6+/-2 years, were recruited consecutively from a pediatric dermatology clinic. No participant had any other medical or psychiatric illness. The control group (n = 9, mean age 7+/-1.8 years) was composed of children with mild "benign" snoring and no evidence of respiratory disturbance during sleep. All participating children were evaluated by formal all-night polysomnography, scratch electrodes, and self-reported questionnaires filled in by their parents.
Results:
The patients were studied when their skin condition was in remission. Sleep latency, total sleep time, and sleep efficiency were similar to the control group. The atopic dermatitis group had an average of 24.1+/-8.1 events per hour of arousals and awakenings, compared with 15.4+/-6.2 events per hour in the control group (P<.001). Direct observation, video monitoring, and scratch electrodes provided evidence of between 1 to 19 bouts of scratching per night, accounting for only 15% of the arousals and awakenings. The rest of the arousals and awakenings were not associated with any specific, identifiable polysomnographic event, such as apnea or jerks.
Conclusion:
Children with atopic dermatitis in clinical remission have sleep disturbances that are not related to scratching per se.