PMID- 25022734
OWN - NLM
STAT- MEDLINE
DCOM- 20140929
LR  - 20211025
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 134
IP  - 2
DP  - 2014 Aug
TI  - Atopic dermatitis, melatonin, and sleep disturbance.
PG  - e397-405
LID - 10.1542/peds.2014-0376 [doi]
AB  - BACKGROUND AND OBJECTIVES: Sleep disturbance is common in patients with atopic 
      dermatitis (AD). However, studies have largely been questionnaire-based, and the 
      pathophysiology remains unclear. The aims of this study were to determine 
      objective characteristics of sleep disturbance in children with AD and explore 
      contributing factors and clinical predictors. METHODS: Sleep parameters were 
      measured by actigraphy and polysomnography in 72 patients with AD and 32 controls 
      ages 1 to 18 years. Urinary 6-sulfatoxymelatonin levels, serum cytokines, and 
      total and allergen-specific immunoglobulin E (IgE) levels were also measured. 
      RESULTS: The patients with AD had significantly reduced sleep efficiency, longer 
      sleep onset latency, more sleep fragmentation, and less nonrapid eye movement 
      sleep. Results from actigraphy correlated well with those from polysomnography. 
      The AD disease severity was associated with sleep disturbance (r = 0.55-0.7), and 
      a Scoring Atopic Dermatitis index of >/=48.7 predicted poor sleep efficiency with a 
      sensitivity of 83.3% and a specificity of 75% (area under the curve = 0.81, P = 
      .001). Lower nocturnal melatonin secretion was significantly associated with 
      sleep disturbance in the patients with AD. Other correlates of sleep disturbance 
      included pruritus, scratching movements, higher total serum IgE levels, and 
      allergic sensitization to dust mite and staphylococcal enterotoxins. CONCLUSIONS: 
      Poor sleep efficiency is common in children with AD and can be predicted by the 
      Scoring Atopic Dermatitis index. Melatonin and IgE might play a role in the sleep 
      disturbance. Further studies are required to explore the mechanisms and clinical 
      implications, and actigraphy could serve as a useful evaluating tool.
CI  - Copyright (c) 2014 by the American Academy of Pediatrics.
FAU - Chang, Yung-Sen
AU  - Chang YS
AD  - Department of Pediatrics, Taipei City Hospital Renai Branch, Taipei City, Taiwan;
FAU - Chou, Yen-Ting
AU  - Chou YT
AD  - Department of Pediatrics, Cardinal Tien Hospital Yonghe Branch, New Taipei City, 
      Taiwan;
FAU - Lee, Jyh-Hong
AU  - Lee JH
AD  - Departments of Pediatrics.
FAU - Lee, Pei-Lin
AU  - Lee PL
AD  - Internal Medicine.
FAU - Dai, Yang-Shia
AU  - Dai YS
AD  - Dermatology, and.
FAU - Sun, Chi
AU  - Sun C
AD  - Departments of Pediatrics.
FAU - Lin, Yu-Tsan
AU  - Lin YT
AD  - Departments of Pediatrics.
FAU - Wang, Li-Chieh
AU  - Wang LC
AD  - Departments of Pediatrics.
FAU - Yu, Hsin-Hui
AU  - Yu HH
AD  - Departments of Pediatrics.
FAU - Yang, Yao-Hsu
AU  - Yang YH
AD  - Departments of Pediatrics.
FAU - Chen, Chun-An
AU  - Chen CA
AD  - Departments of Pediatrics.
FAU - Wan, Kong-Sang
AU  - Wan KS
AD  - Department of Pediatrics, Taipei City Hospital Renai Branch, Taipei City, Taiwan;
FAU - Chiang, Bor-Luen
AU  - Chiang BL
AD  - Departments of Pediatrics,Graduate Institute of Immunology, College of Medicine, 
      National Taiwan University, Taipei, TaiwanMedical Research, National Taiwan 
      University Hospital, Taipei City, Taiwan; and gicmbor@ntu.edu.tw.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140714
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
RN  - 0 (Cytokines)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - JL5DK93RCL (Melatonin)
SB  - IM
MH  - Actigraphy
MH  - Child
MH  - Child, Preschool
MH  - Comorbidity
MH  - Cross-Sectional Studies
MH  - Cytokines/analysis
MH  - Dermatitis, Atopic/*epidemiology/metabolism
MH  - Female
MH  - Humans
MH  - Immunoglobulin E/analysis
MH  - Male
MH  - Melatonin/*metabolism
MH  - Polysomnography
MH  - Sleep Deprivation
MH  - Sleep Wake Disorders/*epidemiology/metabolism
OTO - NOTNLM
OT  - IgE
OT  - SCORAD
OT  - actigraphy
OT  - atopic dermatitis
OT  - dust mite
OT  - melatonin
OT  - polysomnography
OT  - sleep disturbance
OT  - staphylococcal enterotoxin
EDAT- 2014/07/16 06:00
MHDA- 2014/09/30 06:00
CRDT- 2014/07/16 06:00
PHST- 2014/07/16 06:00 [entrez]
PHST- 2014/07/16 06:00 [pubmed]
PHST- 2014/09/30 06:00 [medline]
AID - peds.2014-0376 [pii]
AID - 10.1542/peds.2014-0376 [doi]
PST - ppublish
SO  - Pediatrics. 2014 Aug;134(2):e397-405. doi: 10.1542/peds.2014-0376. Epub 2014 Jul 
      14.