Sleep fragmentation in children with atopic dermatitis

Objective: To characterize the sleep pattern of children with atopic dermatitis in clinical remission. Methods: Fourteen children with atopic dermatitis, with a mean ± SD age of 6 ± 2 years, were recruited consecutively from a pediatric dermatology clinic. No participant had any other medical or psychiatric illness. The control group (n = 9, mean age 7 ± 1.8 years) was composed of children with mild 'benign' snoring and no evidence of respiratory disturbance during sleep. All participating children were evaluated by formal all-night polysomnography, scratch electrodes, and self-reported questionnaires filled in by their parents. Results: The patients were studied when their skin condition was in remission. Sleep latency, total sleep time, and sleep efficiency were similar to the 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 events per hour in the control group (P<.001). Direct observation, video monitoring, and scratch electrodes provided evidence of between 1 to 19 bouts of scratching per night, accounting for only 15% of the arousals and awakenings. The rest of the arousals and awakenings were not associated with any specific, identifiable polysomnographic event, such as apnea or jerks. Conclusion: Children with atopic dermatitis in clinical remission have sleep disturbances that are not related to scratching per se.