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Sleep disturbances in children with atopic dermatitis
R E Dahl1, J Bernhisel-Broadbent, S Scanlon-Holdford
1Department of Psychiatry, University of Pittsburgh (Pa) School of Medicine, USA.
Insights
Children with atopic dermatitis (AD) frequently experience sleep disturbances, including difficulty sleeping and night waking, leading to daytime tiredness and behavioral issues. Addressing sleep problems is crucial for managing AD in children.
Area of Science:
- Pediatric Dermatology
- Sleep Medicine
- Behavioral Science
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting children.
- Clinical observations suggest a link between AD and sleep disturbances.
- Understanding these sleep issues is vital for comprehensive patient care.
Purpose of the Study:
- To investigate the prevalence and nature of sleep problems in children with atopic dermatitis.
- To examine the relationship between AD severity, sleep quality, and daytime behaviors.
- To test hypotheses regarding sleep-related issues in pediatric AD.
Main Methods:
- A cohort of 59 children (ages 5-12) with AD was assessed.
- The Child Sleep Behavior Scale questionnaire was used to evaluate sleep habits.
- Additional questions addressed night-time pruritus and daytime symptoms of inadequate sleep.
Main Results:
- Children with AD exhibited significant sleep difficulties compared to normative data, including trouble falling asleep and frequent night waking.
- Reduced total sleep time and increased difficulty awakening were reported.
- AD severity correlated with sleep problems and daytime behavioral issues like tiredness and irritability.
Conclusions:
- Children with atopic dermatitis commonly suffer from disrupted sleep patterns.
- These sleep disturbances contribute to daytime behavioral difficulties.
- Improving sleep should be a key consideration in the clinical management of pediatric AD.
Objectives:
To test hypotheses based on clinical impressions that children with atopic dermatitis (AD) have frequent sleep-related problems, including difficulty falling asleep, night waking due to itching and scratching, and daytime symptoms of tiredness and irritability.
Design:
Sleep habits and behaviors were assessed using the Child Sleep Behavior Scale (a 22-item Likert-type questionnaire for parents) in children with AD compared with normative data for age. Twelve questions were added to the questionnaire to address sleep-related habits relevant to night time pruritus, and to assess daytime behavioral symptoms of inadequate sleep.
Setting:
Tertiary care center.
Patients:
Fifty-nine children between ages 5 and 12 years meeting criteria for AD representing a referral population to a regional center.
Results:
Compared with normative data, children with AD showed notable differences for nine of the 22 items on the sleep questionnaire, including the following: greater difficulty falling asleep, frequent night waking, less total sleep, and greater difficulty awakening for school. The children with AD also reported frequent daytime tiredness and irritability, and the severity of AD symptoms showed moderate correlations with sleep problems and with daytime behaviors suggestive of inadequate sleep. Difficulty falling asleep and night waking correlated with daytime behavior and discipline problems.
Conclusions:
Children with AD often have disrupted sleep and daytime behavioral difficulties associated with insufficient sleep. Improved sleep may be an important treatment focus in the clinical management of children with AD.