Nocturnal wrist movements are correlated with objective clinical scores and plasma chemokine levels in children with atopic dermatitis

Hon, Kam Lun; Lam, M. C.A.; Leung, Ting Fan; Kam, W. Y.C.; Lee, K. C.K.; Li, M. C.A.; Fok, Tai-fai; Ng, Pak Cheung

doi:10.1111/j.1365-2133.2006.07213.x

Cited by 68 publications

(98 citation statements)

References 20 publications

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“…In previous studies, we also documented that AD-associated chemokine levels (cutaneous T-cell attracting chemokine, macrophage-derived chemokine and thymus and activation-regulated chemokine, all being type 2 T-helper lymphocytespecific chemokines) [19,20] and nocturnal wrist activities (as a surrogate marker of itching) [21] correlated with the extent and the intensity components of SCORAD, but not with subjective symptoms of pruritus or sleep loss. This implies that subjective evaluation and objective status are separately entities.…”

Section: Discussionmentioning

confidence: 51%

“…A HON index of (Obj 1, N 1) is defined as a patient with mild acute and chronic severity, whereas HON (Obj 3, N1) may represent a patient with mild disease over the past 12 months but recent acute exacerbation. Pruritus [21] and sleep disturbance [22] can also be objectively evaluated and documented with the optional portion of the HON classification. In this regard, a HON index of (Obj 1, N1, 40 g min )1 , 90%) represents a patient with mild acute and chronic severity, average wrist movement of 40 g min )1 and sleep efficiency of 90%; whereas HON (Obj 3, N3, 200 g min )1 , 75%) represents a miserable patient with severe disease, intense nocturnal itch and much sleep disturbance.…”

Section: Discussionmentioning

confidence: 99%

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CDLQI, Scorad and Ness: Are they Correlated?

et al. 2006

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

CDLQI, Scorad and Ness: Are they Correlated?

et al. 2006

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“…The different sleeping environments and the attachment of numerous leads and equipment to the patient in the PSG setting could also cause irritation of the skin or other discomfort for the patient with AD, and thus their home sleeping conditions might not be truly reflected. In contrast, actigraphy, a small, wrist-worn device that estimates sleep-wake patterns by using activity-based monitoring, has increasingly been used in recent years for delineating sleep patterns 26,27 because of its ease of use, especially for the pediatric population, 25,28,29 but its validation with PSG measurements in children with AD had not been established. Our study is the first to demonstrate a good correlation of results by actigraphy and PSG in this patient group, and we suggest that actigraphy is a good alternative for further sleep studies in children with AD.…”

Section: Discussionmentioning

confidence: 99%

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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“…13,19,[21][22][23][24][25][26] This study revealed moderately strong correlations between actigraphy scores and both the scratching index and PSG scores, which included sleep latency, sleep efficiency, and stage-2 sleep. Although actigraphy has been presented both as a measure of scratching 20 and sleep, 13 the study by Benjamin et al 20 revealed that actigraphy recordings were significantly and highly correlated with video-recording measures of sleep, scratching, and restlessness.…”

Section: Discussionmentioning

confidence: 99%