Longitudinal Course of Sleep Disturbance and Relationship with Itch in Adult Atopic Dermatitis in Clinical Practice. (Manjunath J. et al., Dermatitis. 2022, Mar 3)
Atopic Dermatitis: The Story
This study examined the progression of sleep disturbance (SD) in adult individuals with atopic dermatitis (AD) over time: in particular, the longitudinal course of difficulty falling asleep and staying asleep were examined. The study also identified predictors of increased SD.
Why it’s Important
Atopic dermatitis is a chronic inflammatory skin condition that is associated with skin irritation including itch, scratch and pain and current estimates show that over 7% of Americans suffer from this condition.
SD is a common occurrence in individuals with AD, often due to the ongoing effects of skin irritation overnight disrupting normal sleep patterns. SD can contribute to further negative effects on the individual including poor mental health, headaches and behavioral problems which can substantially reduce the individual’s quality of life.
Therefore, reducing SD is a crucial step in the effective management of AD. In order to achieve this, factors that impact on quality of sleep must be identified so that patients can be supported effectively beyond the consulting room.
Thus far, most studies have looked at the impact of SD in children with AD, so this study aimed to assess the prevalence of SD in the adult population over time.
This prospective, dermatology practice-based study assessed individuals with atopic dermatitis (N=1295) on sleep disturbance measures. Patients were assessed at baseline and at follow-up visits, which occurred at approximately 6, 12, 18 and 24 months after baseline.
Measures for SD included the Patient-Reported Outcomes Information System (PROMIS) SD and Sleep-Related Impairment (SRI) questionnaires, as well as the Patient-Oriented Eczema Measure (POEM) questionnaire. These questionnaires were collectively used to assess AD severity, SD frequency and severity, frequency of difficulty falling asleep and/or staying asleep, and frequency of days with itch in the past week. Demographic information and patient history of comorbidities were also collected.