Sleep quality in infants with atopic dermatitis: a community-based, birth cohort study

Sleep disturbance has been reported in both pre-school and older children with atopic dermatitis (AD). There have been no studies examining whether sleep disturbance occurs at the onset of the AD, or develops later.

To evaluate sleep characteristics in infants with AD.

A cross-sectional survey based on interviews with parents of infants aged 1 year. AD was diagnosed by showing the parents 3 pictures of typical AD. AD was considered as mild if the rash was a single occurrence or there was only 1 lesion and severe if there were 2 or 3 recurrent or persistent lesions. The infant's sleep behavior was evaluated through information on sleep onset, sleep duration, number of night wakings and the caregivers' perception of problematic sleep behaviors.

Of the total sample, 96.2% (4085 of 4245) provided complete AD information and 148 infants (3.6%) had at least one AD skin lesion. Sleep duration was significantly reduced in infants with severe AD when compared to no-AD infants (542+67 vs 569+62 minutes, p 0.02). The percentage of infants who had night waking with parent intervention required to calm them down "often or always" was significantly higher in mild AD infants than in normal infants (61.7 vs 49.8%, p 0.02). No significant differences were noted between infants with or without AD for other infant sleep behavior.

In AD patients, sleep disturbances can occur early following the onset of the disease. We suggest that clinical assessment of AD infants should take these aspects into consideration.