Association of Atopic Dermatitis With Sleep Quality in Children

Ramirez, Faustine D.; Chen, Shelley; Langan, Sinéad; Prather, Aric A.; McCulloch, Charles E.; Kidd, Sharon A.; Cabana, Michael D.; Chren, Mary Margaret; Abuabara, Katrina

doi:10.1001/jamapediatrics.2019.0025

Cited by 168 publications

(138 citation statements)

References 57 publications

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“…Sleep quality in patients with AD has been evaluated by various subjective tools. Silverberg et al examined sleep disturbance in patients with AD by a cross-sectional questionnaire of 34,613 adults and reported that eczema was associated with fatigue [odds ratio (OD), 2.97], regular daytime sleepiness (OD, 2.66), and regular insomnia (OD, 2.36) [16], roughly in line with a study reported by Li et al in which sleep were detected in 15-65% of children with AD, although total sleep duration was similar between children with active AD and without AD [18]. Thus, the previous studies demonstrated that AD definitely impairs subjective sleep quality.…”

Section: Discussionsupporting

confidence: 86%

Cyclosporine Improves Sleep Quality in Patients with Atopic Dermatitis

Yasuda

Ishiuji

Endo

et al. 2020

Dermatol Ther (Heidelb)

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Introduction: Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease characterized by eczema and pruritus, and frequently impairs sleep quality. Although cyclosporine improves symptoms of AD, objective evaluation of sleep in patients with AD treated with cyclosporine has not been reported. This study was conducted to elucidate the effects of cyclosporine on sleep quality for patients with AD. Methods: Twelve patients with moderate-tosevere AD were recruited. Nocturnal sleep quality was evaluated for 7 days using a sleep analyzer, which patients wore at the waist before and after cyclosporine was administered at 2.0-4.0 mg/kg per day. Seven parameters of sleep quality were measured before and after cyclosporine administration for a period of 7 days for each patient. Results: The administration of cyclosporine significantly improved total sleep time in four cases, sleep latency in two cases, wake after sleep onset in six cases, number of awakenings in two cases, sleep efficiency in seven cases, number of awakenings for more than 8 min in three cases, and number of position changes recorded every 2 min in three cases. The mean values of sleep latency significantly decreased after cyclosporine administration (P = 0.023). The mean value of sleep efficiency significantly increased after the administration (P = 0.002). Conclusion: Cyclosporine improves sleep quality in patients with moderate-to-severe AD.

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Section: Discussionsupporting

confidence: 86%

Cyclosporine Improves Sleep Quality in Patients with Atopic Dermatitis

Yasuda

Ishiuji

Endo

et al. 2020

Dermatol Ther (Heidelb)

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“…For example, Kong, Han, Lee, and Son [25] found that the severity of atopic dermatitis (assessed using the scoring atopic dermatitis scale) and sleep quality (assessed using the children's sleep habits questionnaire) demonstrated significant correlations. Recently, a longitudinal cohort study also found that total sleep duration was similar between children with and without atopic dermatitis; however, children with atopic dermatitis had significantly worse sleep quality from 1 to 16 years of age [26].…”

Section: Discussionmentioning

confidence: 96%

The Pittsburg Sleep Quality Index (PSQI) and Associated Factors in Middle-school Students: A Cross-sectional Study

Park¹

2020

Child Health Nurs Res

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Purpose: The purpose of this study was to evaluate the current level of sleep quality among Korean middle-school students using the Pittsburg Sleep Quality Index (PSQI), and to analyze the factors influencing sleep quality.Methods: The study used a descriptive cross-sectional design and a self-report questionnaire. The participants were 744 middle-school students. The questionnaire included the PSQI and health-related questions, such as the types of diseases they had been diagnosed with and the frequency of hospital admissions. The data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and linear multiple regression.Results: The global PSQI score was 4.21, which indicated good sleep quality. The major factors that were associated with the sleep quality of middle-school students were the number of diseases they had been diagnosed with (β=.54, <i>p</i>=.001) and atopic dermatitis (β=.32, <i>p</i>=.001). In addition, asthma and the frequency of hospital admissions were significant factors influencing each component of the PSQI.Conclusion: The findings from this study suggest that sleep quality was associated with several health-related factors. Thus, nurses, school nurses, and nursing researchers may need to assess the health-related factors associated with adolescents’ sleep quality as part of efforts to improve their sleep quality.

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“…Eczema and related symptoms such as chronic itchiness, red patchy skin appearance and disturbed sleep could negatively affect mental health via social isolation, low self-image, lack of concentration and more irritability, and possibly also via low-grade inflammation and blood-brain barrier disruption. 10,[24][25][26] Conversely, stress, as a proxy of these problems, could shift the balance towards type 2 T helper cells via the hypothalamic-pituitary-adrenal axis and sympathetic adrenomedullary system, leading to more susceptibility to atopic inflammation and diseases, resulting in a vicious cycle. 7 Another explanation is based on shared pathogenesis between eczema and mental health disorders, as both skin cells and neurons originate from the ectoderm.…”

Section: Discussionmentioning

confidence: 99%

Associations of eczema phenotypes with emotional and behavioural problems from birth until school age. The Generation R Study

Nijsten

Pasmans

et al. 2019

Br J Dermatol

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Summary Background Eczema phenotypes and emotional and behavioural problems are highly prevalent in childhood, but their mutual relationship is not fully clear. Objectives To examine the associations of eczema phenotypes with school‐age emotional and behavioural problems, and the bidirectional associations of eczema and emotional and behavioural problems from birth until 10 years. Methods This study among 5265 individuals was embedded in a prospective population‐based cohort study. Never, early transient, mid‐transient, late transient and persistent eczema phenotypes were identified based on parent‐reported, physician‐diagnosed eczema from age 6 months until 10 years. Emotional (internalizing) and behavioural (externalizing) problems were measured repeatedly using the Child Behavior Checklist from age 1·5 to 10 years. Cross‐lagged models were applied for bidirectional analyses. Results All eczema phenotypes were associated with more internalizing problems and attention problems at age 10 years, compared with never having eczema: range of Z‐score differences 0·14 [95% confidence interval (CI) 0·01–0·27] to 0·39 (95% CI 0·18–0·60). Children with early transient eczema had more aggressive behaviour symptoms at age 10 years (Z = 0·16, 95% CI 0·05–0·27). Bidirectional analysis showed that eczema at 0–2 years was associated with more internalizing and externalizing problems at ages 3–6 and 10 years, while, inversely, only internalizing problems at 0–2 years were associated with an increased risk of eczema at age 10 years. Conclusions Eczema phenotypes are very modestly associated with more somatic symptoms and attention problems at school age. Early transient eczema is associated with more aggressive behaviour symptoms. Directional effects seem to occur from early‐life eczema to later‐life internalizing and externalizing problems, rather than the reverse.

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Association of Atopic Dermatitis With Sleep Quality in Children

Cited by 168 publications

References 57 publications

Cyclosporine Improves Sleep Quality in Patients with Atopic Dermatitis

Cyclosporine Improves Sleep Quality in Patients with Atopic Dermatitis

The Pittsburg Sleep Quality Index (PSQI) and Associated Factors in Middle-school Students: A Cross-sectional Study

Associations of eczema phenotypes with emotional and behavioural problems from birth until school age. The Generation R Study

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