Eczema may result in poor sleep quality in kids: JAMA  

Eczema may lead to poor quality sleep in children, suggests a new study.

USA: The study, published in the journal JAMA Pediatrics finds that children with eczema (or atopic dermatitis) - even mild eczema - are more likely to have poor sleep quality compared to children not having this common skin disorder.

Atopic dermatitis ranks among the largest components of the nonfatal disease burden worldwide. Sleep disturbances are identified to decrease life quality in this disorder, but not much is known about their association with sleep in the general population. Pruritus, a hallmark of atopic dermatitis, is often worst at night, resulting in scratching that may interfere with the process of falling asleep and cause disruptions in ongoing sleep.

Eczema can be treated using moisturizers, avoiding certain soaps and other irritants and with prescription creams and ointments containing corticosteroids to relieve itching.

Faustine D. Ramirez, Department of Dermatology Program for Clinical Research, University of California, San Francisco, and colleagues conducted this longitudinal cohort study to determine whether the presence of eczema in children leads to impaired sleep duration and quality at multiple time points throughout childhood and whether disease severity affects sleep outcomes.

For the purpose, the researchers examined data on 13,988 kids, including 4,938, or 35%, with eczema. All had multiple sleep assessments between ages two and 16.

To assess sleep quantity, researchers surveyed mothers about what time kids usually went to bed and woke up; in the final survey, 16-year-olds answered for themselves. Nap times were included in total sleep hours until age seven. Researchers also asked about factors involved in sleep quality including the number of awakenings, difficulty falling asleep, and nightmares.

Key Findings:

• Eczema didn't appear to impact the total amount of sleep kids got. But compared to children without eczema, kids with mild eczema flare-ups were 40% more likely to have lots of sleep disturbances, and those with severe eczema flare-ups had 85% higher odds.


• Even when kids with eczema weren't having active symptoms, they were still 41% more likely to have poor sleep quality throughout childhood than kids without eczema.


• The impairment was stronger among children with more severe disease and (kids who also had) asthma or allergic rhinitis.


• When kids with eczema also had asthma or allergies, they were 52% more likely to have poor quality sleep throughout childhood even when they didn't have active flare-ups.


• When children had asthma or allergies along with severe eczema flare-ups, they were more than twice as likely to sleep poorly.


• Kids with inactive eczema reported these sleep problems as often as children with mild eczema symptoms. And, scratching episodes only accounted for 15% of awakenings.

These findings suggest that flare-ups aren't the only thing contributing to poor sleep quality in kids with eczema, conclude the researchers.