Eczema and sleep and its relationship to daytime functioning in children

Discipline of Paediatrics, School of Paediatrics and Reproductive Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Sleep Medicine Reviews (Impact Factor: 8.51). 04/2010; 14(6):359-69. DOI: 10.1016/j.smrv.2010.01.004
Source: PubMed


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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    • "gical mechanisms of increased inflammation during nighttime could lead to disrupted sleep ( Koinis - Mitchell et al . , 2012 ) . Jernelov et al . reported that the risk for being over - tired in adolescence was increased for children with asthma ( Jer - nelov et al . , 2013 ) . The sleep of children with eczema might be affected by an itchy rash ( Camfferman et al . , 2010 ; Koinis - Mitchell et al . , 2012 ) . Children with allergic rhinitis can suffer from sleep - disordered breathing or snoring which might be due to aggravated nasal congestion during nighttime resulting from the lying posi - tion ( Koinis - Mitchell et al . , 2012 ) . Furthermore , an exposure to mould or dampness at home has been asso"
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    ABSTRACT: There is a general consensus that sleep disruption in children causes daytime behavioral deficits. It is unclear if sleep disruption in children with eczema has similar effects particularly after controlling for known comorbid disorders such as asthma and rhinitis. Parents of children (6-16 y) with eczema (n = 77) and healthy controls (n = 30) completed a validated omnibus questionnaire which included the Sleep Disturbance Scale for Children, Conners Parent Rating Scale-Revised (S), Child Health Questionnaire, Children's Dermatology Life Quality Index, and additional items assessing eczema, asthma, rhinitis, and demographics. Compared to controls, children with eczema had a greater number of sleep problems with a greater percentage in the clinical range, lower quality of life, and higher levels of ADHD and oppositional behavior. They also had elevated rhinitis and asthma severity scores. Importantly, structural equation modelling revealed that the effect of eczema on the behavioral variables of Hyperactivity, ADHD Index, and Oppositional Behaviors were mediated through sleep with no direct effect of eczema on these behaviors. The comorbid atopic disorders of rhinitis and asthma also had independent effects on behavior mediated through their effects on sleep. The present findings suggest that the daytime behaviors seen in children with eczema are mediated independently by the effects of eczema, asthma, and rhinitis on sleep quality. These findings highlight the importance of sleep in eczematous children and its role in regulating daytime behavior.
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