Sleep Disturbances in Children With Atopic Dermatitis: A Scoping Review

Abstract

Atopic dermatitis (AD) is associated with various quality of life concerns including poor sleep. Sleep impairments in children with AD are associated with increased risk of short stature, metabolic syndrome, mental illness and neurocognitive dysfunction. Although the association between AD and sleep disturbance is well established, the specific types of sleep disturbance in pediatric AD patients and their underlying mechanisms are not fully understood. A scoping literature review was performed to characterize and summarize the types of sleep disturbance in children (less than 18 years of age) with AD. 31 papers met inclusion criteria and extracted data were analyzed in an iterative manner. Two types of sleep disturbances were found to be more prevalent in pediatric AD patients in comparison to controls. One category was related to loss of sleep (increased frequency or duration of awakenings, increased sleep fragmentation, delayed sleep onset, decreased total sleep duration, and decreased sleep efficiency). Another category was associated with unusual behaviors during sleep (restlessness/limb movement/scratching, sleep-disordered breathing including obstructive sleep apnea and snoring, nightmares, nocturnal enuresis and nocturnal hyperhidrosis). Some mechanisms underlying these sleep disturbances include pruritus and induced scratching and increased proinflammatory markers induced by sleep loss. Sleep disturbance appears to be associated with AD. We recommend clinicians to consider interventions that may reduce sleep disturbances in children with AD. Further investigation of these sleep disturbances is needed to elucidate pathophysiology, develop additional treatments, and reduce negative impacts on the health outcomes and quality of life in pediatric AD patients.

Food‐induced anaphylaxis during infancy is associated with later sleeping and eating disorders

“…Another important limitation is comorbidity of children with FIA with atopic dermatitis (AD) and asthma; AD and asthma are characteristic of increased Th2‐mediated immunity and can be found in association with FA and FIA. Both AD and asthma were previously linked with sleeping disorders in children 17,18 . However, this comorbidity was not examined in our study, and this should be taken into account when drawing conclusions from our analysis.…”

“…Both AD and asthma were previously linked with sleeping disorders in children. 17,18 However, this comorbidity was not examined in our study, and this should be taken into account when drawing conclusions from our analysis. Lastly, although we found a significant association between FIA and sleeping and eating disorders, we cannot establish a clear causative relationship.…”