Association of Atopic Dermatitis With Sleep Quality in Children

Abstract

To examine whether there is an association of active atopic dermatitis (AD) with sleep duration and sleep quality over multiple time points during childhood.A sample from a longitudinal cohort study of 13 988 children from Avon, United Kingdom, was studied.Data were collected from 1990 to 2008, and AD was determined by a standardized question about flexural dermatitis. Multiple assessments were conducted with the cohort from 1 year of age to age 16, and questions were answered by the mother, except at age 16. Sleep duration was measured as parent report or self-report of time the child usually went to sleep and usually woke up. Sleep disturbance was measured by the child’s nighttime awakenings, regular experience of early morning awakenings, difficulty falling asleep, and nightmares over the past year. Cross-sectional linear and logistic regressions were used for comparing sleep outcomes between children with and without AD; mixed effects models were used for longitudinal analyses for repeated measures of exposures, outcome, and time-varying covariates.Of the study sample, 4938 children (35.3%) met the study criteria for AD. The median duration of follow-up for the cohort was 11 years (interquartile range: 5–14 years). Sleep duration between children with and without AD were similar; and no differences were found by severity of AD in the adjusted model. Children with AD, however, had nearly 50% increased odds of sleep disturbances, compared with children without AD. In addition, children with and without comorbid asthma or allergic rhinitis had worse sleep disturbance with more-severe AD.Although the investigators of the study found no differences in sleep duration between children with and without AD, children with worse AD severity or with comorbid asthma or allergic rhinitis had worse sleep quality outcomes.This study emphasized the sleep quality impairments that pediatric patients might face with AD throughout childhood by leveraging the repeated assessments in their longitudinal birth cohort. Although researcher in cross-sectional and clinical studies have also found similar results with AD and sleep duration and sleep quality, the study adds a population health perspective to the scientific discussion of sleep quality among these children. The findings of the study add to the importance of needing to develop clinically relevant and efficient ways of identifying and ameliorating potential deficits in sleep quality among pediatric AD patients.