Disease severity, scratching, and sleep quality in patients with atopic dermatitis

Bender, Bruce G.; Ballard, Robert D.; Canono, Beth; Murphy, James R.; Leung, Donald Y.M.

doi:10.1016/j.jaad.2007.10.010

Cited by 158 publications

(147 citation statements)

References 36 publications

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“…[7][8][9]31 Our study supports this with finding that more movements in sleep and a higher pruritus score were both associated with lower sleep efficiency. However, it is important to note that arousals caused by limb movement were not significantly correlated with sleep efficiency in our patients (data not shown).…”

Section: Figuresupporting

confidence: 86%

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Atopic Dermatitis, Melatonin, and Sleep Disturbance

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Sleep disturbance affects 47% to 60% of children with atopic dermatitis and is a leading cause of impaired quality of life for the patients and their family. WHAT THIS STUDY ADDS:Sleep disturbance in children with atopic dermatitis can be predicted by a Scoring Atopic Dermatitis index of $48.7, and lower nocturnal melatonin secretion might play a role in the pathophysiology. abstract BACKGROUND AND OBJECTIVES: Sleep disturbance is common in patients with atopic dermatitis (AD). However, studies have largely been questionnaire-based, and the pathophysiology remains unclear. The aims of this study were to determine objective characteristics of sleep disturbance in children with AD and explore contributing factors and clinical predictors.METHODS: Sleep parameters were measured by actigraphy and polysomnography in 72 patients with AD and 32 controls ages 1 to 18 years. Urinary 6-sulfatoxymelatonin levels, serum cytokines, and total and allergen-specific immunoglobulin E (IgE) levels were also measured. RESULTS:The patients with AD had significantly reduced sleep efficiency, longer sleep onset latency, more sleep fragmentation, and less nonrapid eye movement sleep. Results from actigraphy correlated well with those from polysomnography. The AD disease severity was associated with sleep disturbance (r = 0.5520.7), and a Scoring Atopic Dermatitis index of $48.7 predicted poor sleep efficiency with a sensitivity of 83.3% and a specificity of 75% (area under the curve = 0.81, P = .001). Lower nocturnal melatonin secretion was significantly associated with sleep disturbance in the patients with AD. Other correlates of sleep disturbance included pruritus, scratching movements, higher total serum IgE levels, and allergic sensitization to dust mite and staphylococcal enterotoxins. CONCLUSIONS:Poor sleep efficiency is common in children with AD and can be predicted by the Scoring Atopic Dermatitis index. Melatonin and IgE might play a role in the sleep disturbance. Further studies are required to explore the mechanisms and clinical implications, and actigraphy could serve as a useful evaluating tool. Atopic dermatitis (AD) is a common chronically relapsing pruritic inflammatory skin disease. 1 Disturbed sleep is frequently reported by the patients and their family and is a major factor leading to an impaired quality of life. [2][3][4] Sleep disturbance can have many negative consequences, including impaired neurocognitive function, higher rates of behavioral problems, and changes in mood. 5,6 Therefore, the recognition and proper management of sleep disturbance should be an important issue in AD.The sleep disturbance in AD might be due to the pruritus and scratching movements during sleep, 7-10 but it is likely that other factors are involved. 11 Melatonin is a hormone secreted by the pineal gland that is essential for regulating the circadian rhythm. 12 Dysfunction in the diurnal secretion of melatonin in patients with AD has been reported, 13 but its association with their sleep disturbance has...

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Section: Figuresupporting

confidence: 86%

“…The sleep disturbance in AD might be due to the pruritus and scratching movements during sleep, [7][8][9][10] but it is likely that other factors are involved. 11 Melatonin is a hormone secreted by the pineal gland that is essential for regulating the circadian rhythm.…”

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confidence: 99%

Atopic Dermatitis, Melatonin, and Sleep Disturbance

et al. 2014

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“…Patients with obstructive sleep apnea have approximately twofold greater risk of developing psoriasis [74]. In atopic dermatitis, the scratching episodes cause sleep fragmentation [8,52]. Children with eczema also present disturbed sleep because of nocturnal itching and scratching, and possibly due to comorbidities as allergic rhinitis and asthma [14].…”

Section: Introductionmentioning

confidence: 99%

Could adult female acne be associated with modern life?

et al. 2014

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In recent years, the prevalence of adult female acne has increased, but the reason for this increase remains unclear. Acne is one of the most common skin disorders. It can be triggered or worsened by endogenous and exogenous factors, including genetic predisposition, hormone concentrations, diet, smoke and stress; although the interaction with this last factor is not well understood. Modern life presents many stresses including urban noises, socioeconomic pressures and light stimuli. Women are especially affected by stress during daily routine. The recent insertion in the labor market is added to the duties of the mother and wife. Women also have a higher risk of developing psychiatric disorders such as depression and anxiety. Sleep restriction is added to these factors, with several negative consequences on health, including on hormonal secretion and the immune system. This is further complicated by the natural variation in sleep architecture across the menstrual cycle. Recent studies have brought new data about the mechanisms and possible factors involved. This review aims to establish a connection between stress, sleep deprivation and adult female acne.

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“…Furthermore, eczema conferred additional risk of FBJI compared with fatigue or sleep disturbance alone. Previous studies [7][8][9][10][11] demonstrated high rates of sleep disturbance in adults with eczema. In particular, eczema seems to result in lower sleep quality, decreased overall sleep efficiency, and increased daytime dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep disturbance was also measured by means of self-report. Previous studies 8,45 found strong correlation between self-report of fatigue and daytime sleepiness and objective measures of sleep disturbance (ie, actigraphy and polysomnography). and other disorders.…”

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confidence: 90%