P209 sleep health care disparities in pediatric children with asthma: does atopic dermatitis increase risk?
Children with asthma are at risk for poorer sleep outcomes. Urban minority children are disproportionately burdened by poor sleep due to sociocontextual stressors and challenges with asthma regimens. Atopic dermatitis (AD) is highly co-morbid in children with asthma and can further increase risk for poor sleep. Our study goal was to examine the sleep outcomes in urban children with asthma and determine whether AD increased risk for poorer sleep utilizing a group of urban healthy children as controls.
Abstract BACKGROUND: Little is known about the measurement properties of Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD) in adults with AD. Even less is known about how PO-SCORAD performs compared to the Patient-Oriented Eczema Measure (POEM). OBJECTIVE: To examine the measurement properties of PO-SCORAD and compare them with POEM. METHODS: A prospective dermatology-practice based study of 291 AD patients (age 1872 years). RESULTS: PO-SCORAD and POEM were moderately correlated with each other (Spearman rho=0.56); had weak-moderate correlations with Numeric Rating Scale (NRS) worst-itch and av...
Urban minority with asthma are at risk for poorly controlled asthma as well as poorer sleep outcomes. Atopic dermatitis (AD) is frequently present in children with asthma and can increase risk for poor quality sleep. Our study examined sleep and asthma outcomes in urban children with asthma and whether co-existing AD increased risk for poorer asthma outcomes and sleep quality.
PMID: 31923547 [PubMed - as supplied by publisher]
Atopic dermatitis (AD) impacts up to 20% of children worldwide (1;2). Children with AD experience physical discomfort, poorer quality of life (3-5), increased behavior problems (6;7), higher frequency of attention-deficit/hyperactivity disorder (ADHD) (8-11) and higher healthcare utilization (12). Parents of children with AD report decreased quality of life (13-16), negative impact on the family (14;17), increased depression and anxiety (16), and increased work absenteeism (18;19).
Atopic dermatitis (AD) is a common childhood disorder that is associated with a variety of negative health outcomes in children and parents, including poor sleep and daytime functioning. Despite this, few studies have examined the impact of treatment for AD on sleep, and even fewer have included validated sleep questionnaires, child report of sleep disturbance, or objective measures of sleep.
Recent studies have highlighted the multidimensional effect of atopic dermatitis (AD) and urticaria. Patient burden for these conditions is largely driven by the intense itching, sleep disturbance, comorbidities, and mental health illness associated with these diseases.1-3 Immunologic, microbial, and epithelial interactions have been reported to play an important role in AD.4,5 Novel therapies and management approaches are targeting the mechanisms underlying AD and urticaria.6,7 The current issue of the Annals contains 3 outstanding reviews that update readers on the pathophysiology and evolving treatments for AD and chronic urticaria.
Abstract BACKGROUND: The optimal approaches for monitoring sleep disturbances in adults with atopic dermatitis (AD) is not established. Multiple patient-reported outcome measures for AD and itch have sleep-related items. These items have not been validated previously. OBJECTIVE: Assess the measurement properties of sleep-related items from the Patient- Oriented Eczema Measure (POEM), SCORing AD (SCORAD), 5-dimensions of itch (5D) and ItchyQOL in adults with AD. METHODS: We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n=115). RESULTS...
The optimal approaches for monitoring sleep disturbances in adults with atopic dermatitis (AD) is not established. Multiple patient-reported outcome measures for AD and itch have sleep-related items. These items have not been validated previously.
The immediate priority for clinicians managing patients with atopic dermatitis (AD) is treating the disease, particularly the constant itch and sleep disturbance, with its consequential disruption of both home and work life and association with low mood, poorer concentration, and productivity. However, long-term sequelae are important to consider and include those directly related to the atopic march (asthma, allergic rhinoconjunctivitis, and food allergies), the consequences of having a chronic disease, and potential side effects of therapy, particularly topical corticosteroids.
Discussion Atopic dermatitis (AD) has a prevalence of 3-5% in the overall U.S. population but is increasing with an estimated 10-15% lifetime risk in childhood. It is even more common in children of color with a prevalence in African-American/black children of 17% and Hispanic children of 14%. Health care utilization data also appears to support more severe disease in children of color also. Atopic dermatitis or eczema is a common dermatological skin problem which characteristically is a pruritic, papular eruption with erythema. Like most papulosquamous eruptions it often occurs in intertrigenous areas in people with alle...