Sleep Disturbance in School-Aged Children with Atopic Dermatitis: Prevalence and Severity in a Cross-Sectional Sample

被引:34
作者
Fishbein, Anna B. [1 ]
Cheng, Brian T. [2 ,3 ]
Tilley, Caroline C. [1 ]
Begolka, Wendy Smith [4 ]
Carle, Adam C. [5 ,6 ]
Forrest, Christopher B. [7 ]
Zee, Phillis C. [8 ]
Paller, Amy S. [2 ,3 ]
Griffith, James W. [9 ]
机构
[1] Northwestern Univ, Ann & Robert H Lurie Childrens Hosp Chicago, Dept Pediat, Div Allergy Immunol,Feinberg Sch Med, Chicago, IL 60611 USA
[2] Northwestern Univ, Dept Dermatol, Feinberg Sch Med, Chicago, IL 60611 USA
[3] Northwestern Univ, Dept Pediat, Feinberg Sch Med, Chicago, IL 60611 USA
[4] Natl Eczema Assoc, Novato, CA USA
[5] Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati Childrens Hosp, Cincinnati, OH USA
[6] Univ Cincinnati, Dept Psychol, Coll Arts & Sci, Cincinnati, OH 45221 USA
[7] Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Dept Pediat, Philadelphia, PA 19104 USA
[8] Northwestern Univ, Dept Neurol, Feinberg Sch Med, Chicago, IL 60611 USA
[9] Northwestern Univ, Dept Med Social Sci, Feinberg Sch Med, Chicago, IL 60611 USA
基金
美国医疗保健研究与质量局;
关键词
Atopic dermatitis; Pediatric; Quality of life; Sleep; PROMIS; Attention; Mental health; Depression; Anxiety; Neurocognitive function; HYPERACTIVITY DISORDER; ECZEMA; ASSOCIATION;
D O I
10.1016/j.jaip.2021.04.064
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: Atopic dermatitis (AD) causes sleep disturbance but the epidemiology is not known. OBJECTIVE: To estimate the US prevalence of sleep disturbance and its impact on psychological and neurocognitive function. METHODS: We conducted a cross-sectional survey of 180 parent-child dyads with AD using stratified sampling based on disease severity (Patient Oriented Eczema Measure: mild [n = 30), moderate (n = 75) or severe (n = 75]), age, and race (White or Black or African American or other). Symptoms of sleep and psychologic health were assessed using the Patient Reported Outcome Measurement Information System. To estimate the prevalence of sleep disturbance, we calculated weights using poststratification adjustment making marginal frequencies of AD severity, race, and age similar to marginal frequencies in the 2007 National Survey of Children's Health. Unweighted regression models examined associations with sleep disturbance. RESULTS: In children age 5 to 17 years with AD, we estimated that sleep disturbance occurred in 66.9% (95% confidence interval, 53.3% to 80.5%; 3,116,305 children). The odds of severe sleep disturbance (worse than 95% of US children) were highest in moderate to severe versus mild AD (2.03 [1.00-4.10]; P = .0495; compared with 8.68 [1.82-41.49]; P = .0068). Predictors of parent proxy-reported sleep disturbance were itch intensity (adjusted beta [95% confidence interval] 1.33 [0.62-2.04]) and low income (<$50,000: 6.64 [2.05-11.23]; and $50,000 to less than 100,000: 4.75 [0.35-9.14]). Controlling for disease severity, itch intensity, and significant sociodemographicsparent-proxy, reported sleep disturbance was associated with increased severity of sleep-related impairment, depression, fatigue, and anxiety, in addition to worse inattention and impulsivity. In fully adjusted models, children who self-reported sleep disturbance (T-score >= 60) had increased odds of sleep-related impairment (1.20 [1.11-1.29]), depression (1.13 [1.03, 1.24]), fatigue (1.28 [1.06-1.54]), and anxiety (1.16 [1.021.31]). CONCLUSIONS: Sleep disturbance is a common symptom of AD. It affects about 3 million US children and is associated with neuropsychiatric impairment, including depression, anxiety, and inattention. Clinicians should screen for these symptoms in school-aged children, particularly those with moderate to severe AD. (C) 2021 American Academy of Allergy, Asthma & Immunology
引用
收藏
页码:3120 / +
页数:13
相关论文
共 34 条
[1]  
Armstrong J.M., 2003, MANUAL MACARTHUR HLT
[2]   Sleep disorders in patients with asthma, atopic dermatitis, and allergic rhinitis [J].
Bender, BG ;
Leung, DYM .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2005, 116 (06) :1200-1201
[3]   Sleep Health: Can We Define It? Does It Matter? [J].
Buysse, Daniel J. .
SLEEP, 2014, 37 (01) :9-U219
[4]   Eczema and sleep and its relationship to daytime functioning in children [J].
Camfferman, Danny ;
Kennedy, John D. ;
Gold, Michael ;
Martin, Alfred J. ;
Lushington, Kurt .
SLEEP MEDICINE REVIEWS, 2010, 14 (06) :359-369
[5]   Using nationally representative percentiles to interpret PROMIS pediatric measures [J].
Carle, Adam C. ;
Bevans, Katherine B. ;
Tucker, Carole A. ;
Forrest, Christopher B. .
QUALITY OF LIFE RESEARCH, 2021, 30 (04) :997-1004
[6]   Effects of atopic dermatitis on young American children and their families [J].
Chamlin, SL ;
Frieden, IJ ;
Williams, ML ;
Chren, MM .
PEDIATRICS, 2004, 114 (03) :607-611
[7]   Translating Patient-Oriented Eczema Measure (POEM) scores into clinical practice by suggesting severity strata derived using anchor-based methods [J].
Charman, C. R. ;
Venn, A. J. ;
Ravenscroft, J. C. ;
Williams, H. C. .
BRITISH JOURNAL OF DERMATOLOGY, 2013, 169 (06) :1326-1332
[8]   Infant sleep and child mental health: a longitudinal investigation [J].
Cook, Fallon ;
Conway, Laura J. ;
Giallo, Rebecca ;
Gartland, Deirdre ;
Sciberras, Emma ;
Brown, Stephanie .
ARCHIVES OF DISEASE IN CHILDHOOD, 2020, 105 (07) :655-660
[9]   Burden of illness in adults with atopic dermatitis: Analysis of National Health and Wellness Survey data from France, Germany, Italy, Spain, and the United Kingdom [J].
Eckert, Laurent ;
Gupta, Shaloo ;
Gadkari, Abhijit ;
Mahajan, Puneet ;
Gelfand, Joel M. .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2019, 81 (01) :187-195
[10]   Guidelines of care for the management of atopic dermatitis Section 1. Diagnosis and assessment of atopic dermatitis [J].
Eichenfield, Lawrence F. ;
Tom, Wynnis L. ;
Chamlin, Sarah L. ;
Feldman, Steven R. ;
Hanifin, Jon M. ;
Simpson, Eric L. ;
Berger, Timothy G. ;
Bergman, James N. ;
Cohen, David E. ;
Cooper, Kevin D. ;
Cordoro, Kelly M. ;
Davis, Dawn M. ;
Krol, Alfons ;
Margolis, David J. ;
Paller, Amy S. ;
Schwarzenberger, Kathryn ;
Silverman, Robert A. ;
Williams, Hywel C. ;
Elmets, Craig A. ;
Block, Julie ;
Harrod, Christopher G. ;
Begolka, Wendy Smith ;
Sidbury, Robert .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2014, 70 (02) :338-351