O02 Assessing SleeP in INfants with moderate-severe atopic Dermatitis by Longitudinal Evaluation (The SPINDLE study)

Abstract

Abstract Introduction Atopic dermatitis (AD) is associated with sleep disruption due to pruritus, inflammation, increased transepidermal water loss (TEWL) and circadian alterations. Little is known about the impact of AD on sleep in early infancy, a critical time for neurodevelopment. The aim of this study was to deeply characterise the sleep architecture of 6-month-old infants with moderate-severe AD, compared to controls. Methods Overnight movements (defined as 10-15 seconds of movement) were measured for five consecutive nights using a novel wearable movement sensor. Infantile and parental sleep measures were reported by parents. Daytime sleep quality and quantity was measured by electroencephalogram (EEG) polysomnography. AD was assessed using clinical severity scoring, skin barrier assessment (TEWL, natural moisturising factor levels, and filaggrin mutational analysis) and inflammatory cytokine analysis by tape stripping. Results 57 controls and 33 cases were recruited. Average EASI at time of 6-month assessment was 7.2 (range 0.8-34.8). Infants with AD recorded almost twice as many overnight movements as controls (19.2 versus 11.2, p<0.05). Infants with AD slept for 13.1 hours versus 13.8 (p<0.05), and woke 3.5 times versus 1.9 (p<0.05). Infants with AD had differences in EEG sleep measures, including sleep spindle power and frequency. Mothers of cases had worse total sleep time (6.3 versus 7.1 hours, p<0.05), sleep-­onset latency (27.1 versus 12.8 minutes, p<0.05), and sleep ­efficiency. Conclusion This is the most detailed study ever performed on sleep in infants with AD using objective sleep measures, and has revealed significant effects on sleep architecture, sleep duration, and overnight movement.