Sleep fragmentation in children with atopic dermatitis

Objective: To characterize the sleep pattern of children with atopic dermat itis in clinical remission. Methods: Fourteen children with atopic dermatitis, with a mean +/- SD age o f 6 +/- 2 years, were recruited consecutively from a pediatric dermatology clinic. No participant had any other medical or psychiatric illness. The co ntrol group (n=9, mean age 7+/-1.8 years) was composed of children with mil d "benign" snoring and no evidence of respiratory disturbance during sleep. All participating children were evaluated by formal all-night polysomnogra phy, scratch electrodes, and self-reported questionnaires filled in by thei r parents. Results: The patients were studied when their skin condition was in remissi on. Sleep latency, total sleep time, and sleep efficiency were similar to t he control group. The atopic dermatitis group had an average of 24.1 +/- 8. 1 events per hour of arousals and awakenings, compared with 15.4 +/- 6.2 ev ents per hour in the control group (P<.001). Direct observation, video moni toring, and scratch electrodes provided evidence of between 1 to 19 bouts o f scratching per night, accounting for only 15% of the arousals and awakeni ngs. The rest of the arousals and awakenings were not associated with any s pecific, identifiable polysomnographic event, such as apnea or jerks. Conclusion: Children with atopic dermatitis in clinical remission have slee p disturbances that are not related to scratching per se.