Atopic dermatitis, melatonin, and sleep disturbance
Journal
Pediatrics
Journal Volume
134
Journal Issue
2
Pages
e397-e405
Date Issued
2014
Author(s)
Chang Y.-S.
Chou Y.-T.
Sun C.
Wan K.-S.
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 = 0.55-0.7), 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. Copyright ? 2014 by the American Academy of Pediatrics.
SDGs
Other Subjects
6 hydroxymelatonin o sulfate; gamma interferon; immunoglobulin E; interleukin 31; interleukin 4; melatonin; actimetry; adolescent; adult; article; atopic dermatitis; child; controlled study; disease association; disease severity; female; hormone release; house dust allergy; human; immunoglobulin blood level; major clinical study; male; named inventories, questionnaires and rating scales; nonREM sleep; polysomnography; priority journal; pruritus; Scoring Atopic Dermatitis index; sensitivity and specificity; sleep disorder; sleep quality; sleep time; actigraphy; atopic dermatitis; dust mite; IgE; melatonin; polysomnography; SCORAD; sleep disturbance; staphylococcal enterotoxin; Actigraphy; Child; Child, Preschool; Comorbidity; Cross-Sectional Studies; Cytokines; Dermatitis, Atopic; Female; Humans; Immunoglobulin E; Male; Melatonin; Polysomnography; Sleep Deprivation; Sleep Disorders
Publisher
American Academy of Pediatrics
Type
journal article