SLEEP DISTURBANCES IN CHILDREN WITH ATOPIC-DERMATITIS

Objectives: To test hypotheses based on clinical impressions that chil dren with atopic dermatitis (AD) have frequent sleep-related problems, including difficulty falling asleep, night waking due to itching and scratching, and daytime symptoms of tiredness and irritability. Design : Sleep habits and behaviors were assessed using the Child Sleep Behav ior Scale (a 22-item Likert-type questionnaire for parents) in childre n with AD compared with normative data for age. Twelve questions were added to the questionnaire to address sleep-related habits relevant to night time pruritus, and to assess daytime behavioral symptoms of ina dequate sleep. Setting: Tertiary care center. Patients: Fifty-nine chi ldren between ages 5 and 12 years meeting criteria for AD representing a referral population to a regional center. Results: Compared with no rmative data, children with AD showed notable differences for nine of the 22 items on the sleep questionnaire, including the following: grea ter difficulty falling asleep, frequent night waking, less total sleep , and greater difficulty awakening for school. The children with AD al so reported frequent daytime tiredness and irritability, and the sever ity of AD symptoms showed moderate correlations with sleep problems an d with daytime behaviors suggestive of inadequate sleep. Difficulty fa lling asleep and night waking correlated with daytime behavior and dis cipline problems. Conclusions: Children with AD often have disrupted s leep and daytime behavioral difficulties associated with insufficient sleep. Improved sleep may be an important treatment focus in the clini cal management of children with AD.