Eczema and sleep and its relationship to daytime functioning in children.
ABSTRACT Chronic childhood eczema has significant morbidity characterised by physical discomfort, emotional distress, reduced child and family quality-of-life and, of particular note, disturbed sleep characterised by frequent and prolonged arousals. Sleep disturbance affects up to 60% of children with eczema, increasing to 83% during exacerbation. Even when in clinical remission, children with eczema demonstrate more sleep disturbance than healthy children. Notably, disturbed sleep in otherwise healthy children is associated with behavioural and neurocognitive deficits. Preliminary evidence suggests that disturbed sleep in children with eczema is also associated with behavioural deficits while the impact on neuropsychological functioning remains unexplored. In conclusion, a disease which affects up to 20% of children in some countries and may produce long-term behavioural and neurocognitive deficits merits further evaluation using standardised tests of sleep, behaviour and neurocognition.
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ABSTRACT: Exposure to mould or dampness at home has been associated with adverse respiratory effects in all age groups. This exposure has also been related to insomnia in adults. We aimed to investigate the association between exposure to visible mould or dampness at home and sleep problems in children.Environmental Research 02/2015; 137. DOI:10.1016/j.envres.2014.11.023 · 3.95 Impact Factor
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ABSTRACT: Objective To examine sleep, neurocognitive and behavioural functioning in children and adolescents with Type 1 diabetes (T1D) compared to controls and to test whether sleep quality mediates the relationship between diabetes and neurocognitive and behavioural deficits. Methods Participants include 49 children and adolescents with T1D (recruited from a hospital clinic) and 36 healthy controls (age range = 6-16y). Parents completed a survey consisting of the Sleep Disturbances Scale for Children, the Behavior Rating Inventory of Executive Functions, and the Behavior Assessment System for Children-2. Diabetic and demographic parameters were collated from medical records. The survey was posted to participants. Results Children with T1D compared to controls reported a higher frequency of sleep problems, and mild deficits in executive and behavioural functioning. Mediational analyses revealed that sleep quality fully mediated metacognitive functioning, externalised problematic behaviour and internalised problematic behaviour, but not behavioural regulation. Conclusions Rather than the direct impact of T1D on daytime functioning, it is the consequent impact of T1D on sleep and the resulting sleep disruption which can explain much of the neurocognitive and behavioural deficits reported in children with T1D. Maintaining good nocturnal glycaemic control may play a much larger role than previously thought in regulating daytime functioning in children with T1D.Sleep Medicine 09/2014; 15(12). DOI:10.1016/j.sleep.2014.08.011 · 3.10 Impact Factor
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ABSTRACT: Sleep disturbances are associated with poor health outcomes in adults. However, little is known about the sleep disturbances that occur in adult eczema. We studied the association between adult eczema and sleep disturbance and their impact on overall health and healthcare utilization. We used the 2012 National Health Interview Survey, a cross-sectional, questionnaire of 34,613 adults. Eczema was associated with higher odds of fatigue (odds ratio [95% CI]: 2.97 [2.65-3.34]), regular daytime sleepiness (2.66 [2.34-3.01]) and regular insomnia (2.36 [2.11-2.64]), even after controlling for sleep duration, history of allergic disease, socio-demographics and body mass index. There were significant interactions between eczema and fatigue, sleepiness and insomnia as predictors of poorer overall health status, number of sick days and doctor visits, such that eczema and each of the sleep symptoms was associated with higher odds of poorer outcomes than either eczema or sleep symptoms alone. Latent class analysis was used and identified 5 classes of fatigue, sleep disturbances and allergic disorders. Two classes had high probabilities of eczema; one with high probabilities of asthma, hay fever, food allergy and multiple sleep symptoms; the other with intermediate probability of insomnia alone. Future studies are warranted to better characterize sleep loss in eczema and develop strategies for treatment and prevention.Journal of Investigative Dermatology accepted article preview online, 31 July 2014; doi:10.1038/jid.2014.325.Journal of Investigative Dermatology 07/2014; 135(1). DOI:10.1038/jid.2014.325 · 6.37 Impact Factor