Sleep disturbance in children with moderate/severe atopic dermatitis: A case-control study

Anna Fishbein*, Kelly Mueller, Lacey Lea Kruse, Peter Boor, Stephen H Sheldon, Phyllis C Zee, Amy Paller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Background: Sleep is disturbed in 60% of children with atopic dermatitis (AD). Objective: To characterize sleep in a cohort of children with moderate-to-severe AD and determine methods for assessment of sleep disturbance. Methods: A case-control study compared children age 6 to 17 years who have moderate-to-severe AD with age- and sex-matched healthy controls. Participants wore actigraphy watches and completed sleep- and disease-specific questionnaires. Results: Nineteen patients with AD and 19 controls completed the study. The patients with AD experienced wake after sleep onset (WASO) for 103 plus or minus 55 minutes as compared with 50 plus or minus 27 minutes in the controls (P <.01). They had a higher frequency of restless sleep, daytime sleepiness, difficulty falling back to sleep at night, and teacher-reported daytime sleepiness. Disease severity correlated well with WASO (total SCORing Atopic Dermatitis score: r = 0.61, P <.01; objective SCORing Atopic Dermatitis score: r = 0.58, P =.01; and Eczema Area and Severity Index: r = 0.68, P <.01). The Children's Dermatology Life Quality Index sleep question correlated with WASO (r = 0.52, P =.03), but self-reported itch severity did not (r = 0.28, P =.30). Limitations: The study cohort was small. Conclusion: Children with moderate-to-severe AD experience more WASO and lower sleep efficiency than healthy controls but similar bedtime and wake time, sleep duration, and sleep onset latency.

Original languageEnglish (US)
Pages (from-to)336-341
Number of pages6
JournalJournal of the American Academy of Dermatology
Issue number2
StatePublished - Feb 2018


  • actigraphy
  • atopic dermatitis
  • circadian
  • itch
  • nocturnal
  • scratch
  • screening
  • sleep
  • sleep disturbance
  • wake after sleep onset

ASJC Scopus subject areas

  • Dermatology


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