Prevalence of sleep disorders in atopic dermatitis: a systematic review and meta-analysis

The aim of this meta-analysis was to determine the prevalence of sleep disorders among patients with atopic dermatitis (AD) and to explore the association between AD and sleep disorders. This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was prospectively registered in the International Prospective Systematic Review Registry (PROSPERO) database (registration number: CRD42024498045). Only English-written cross-sectional studies reporting the prevalence of sleep disorders in patients with AD were included in this analysis. We searched four databases: EMBASE, Web of Science, PubMed and the Cochrane Library as of 9 February 2025. Studies were screened using EndNote X9.1. Data were analyzed using STATA V15.0 software. Initially, a total of 861 studies were searched from databases. Ultimately, 32 studies including 85,921 participants were included in this meta-analysis. The prevalence of sleep disorders among individuals with AD was estimated using a random-effects model. The degree of heterogeneity was assessed by I² statistic. If significant heterogeneity was detected, the source of heterogeneity was determined by meta-regression, and sensitivity analyses were then conducted by sequentially excluding each study to assess the robustness of the findings. This analysis revealed that the combined prevalence of sleep disorders among patients with AD was 43.4% (95% confidence interval: 39.7%-47.1%). Subgroup analyses were conducted according to region, data source, year of publication, severity of AD, sleep disorder assessment scales, classification of sleep problems, nocturnal awakenings, and number of days of sleep disorders experienced per week.