Sleep Fragmentation in Children With Atopic Dermatitis

Reuveni, Haim; Chapnick, Gil; Tal, Asher; Tarasiuk, Ariel

doi:10.1001/archpedi.153.3.249

Cited by 103 publications

(89 citation statements)

References 24 publications

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“…Indeed, family stress explained some of the increased risk of childhood asthma. Asthma and hay fever symptoms, and atopic dermatitis-related pruritis, may be the cause of disrupted sleep in cross-sectional studies of older children [2,18,47,48]. We also recognise the possibility that reverse causation may be responsible for our findings in infants because wheeze during infancy can cause nocturnal awakening and is a marker for future asthma [28,49].…”

Section: Discussionmentioning

confidence: 67%

Frequent nocturnal awakening in early life is associated with nonatopic asthma in children

Kozyrskyj¹,

Kendall²,

Zubrick³

et al. 2009

Eur Respir J

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Sleep deprivation has become a common phenomenon of the Western world and is associated with a variety of medical problems in children. This retrospective longitudinal analysis of a community-based birth cohort was undertaken to determine whether frequent nocturnal awakening during early life was associated with the development of childhood asthma.2,398 children born to mothers recruited from the antenatal clinics of a single hospital in Perth, Australia during 1989-1991 were followed up at years 1, 2, 3, 6, 8, 10 and 14. Parent-completed questionnaires were analysed. The odds ratio for asthma at age 6 and 14 yrs in children with frequent nocturnal awakening during the first 3 yrs after birth was determined from multiple logistic regression.Following adjustment for asthma risk factors, co-sleeping and family stress, persistent nocturnal awakening was associated with nonatopic asthma at age 6 and 14 yrs (at age 14 yrs: OR 2.18, 95% CI 1.15-4.13) but not with atopic asthma.We found an increased risk of nonatopic asthma in children following frequent nocturnal awakening during the first 3 yrs of life. These hypothesis-generating data suggest the need for further systematic study of the effects of disordered sleep in early life on the development of asthma.

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Section: Discussionmentioning

confidence: 67%

Frequent nocturnal awakening in early life is associated with nonatopic asthma in children

Kozyrskyj¹,

Kendall²,

Zubrick³

et al. 2009

Eur Respir J

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“…A possible limitation of the present study is the ''first-night effect'', which may affect the sleep architecture of individuals during their first night of the PSG evaluation. However, in a previous study we have shown that the only significant change between two consecutive nocturnal PSG studies was in REM sleep [25]. No change was noted in SWA in the comparison group between the two PSG studies, where each patient served as their own control; thus, we do not think the first-night effect affects our interpretations.…”

Section: Subjectsmentioning

confidence: 60%

Adenotonsillectomy improves slow-wave activity in children with obstructive sleep apnoea

Ben-Israel¹,

Zigel²,

Tal³

et al. 2010

Eur Respir J

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The aim of the present study was to estimate slow-wave activity (SWA), a marker of sleep homeostasis, in children with obstructive sleep apnoea (OSA) before and after adenotonsillectomy (AT) compared with untreated OSA children (comparison group).14 children with OSA (mean¡SD age 6.4¡2.5 yrs; apnoea-hypopnoea index (AHI) 10.0¡10.3 events?h -1 ) who underwent AT were consecutively recruited to the study. The comparison group comprised six retrospectively recruited children (age 5.4¡2.2 yrs; AHI 9.4¡7.6 events?h -1 ) with OSA that did not undergo treatment. Electroencephalogram (derivation C3/A2) was analysed using spectral and waveform analysis to determine SWA energy and slowwave slope. The same procedure was repeated 5.4 and 19 months later for the AT and comparison groups, respectively.AT improved respiration without a change in duration of sleep stages. Following AT, .50% elevation of SWA during the first two sleep cycles (p,0.01) and a more physiological decay of SWA across the night (p,0.0001) were noted. The slow-wave slope increased by .30% following AT (p,0.03). No significant changes were found in SWA in the comparison group.Sleep homeostasis is considerably impaired in pre-pubescent children with OSA. AT restores more physiological sleep homeostasis in children with OSA. SWA analysis may provide a useful addition to standard sleep-stage analyses in children with OSA.

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“…A previous study also revealed that scratching accounted for only 15% of arousals in patients with AD. 11 Therefore, scratching movements play a part in the sleep disturbance of patients with AD, but are unlikely the sole etiology.…”

Section: Figurementioning

confidence: 99%

“…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 not been studied.…”

mentioning

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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Sleep Fragmentation in Children With Atopic Dermatitis

Cited by 103 publications

References 24 publications

Frequent nocturnal awakening in early life is associated with nonatopic asthma in children

Frequent nocturnal awakening in early life is associated with nonatopic asthma in children

Adenotonsillectomy improves slow-wave activity in children with obstructive sleep apnoea

Atopic Dermatitis, Melatonin, and Sleep Disturbance

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