Children With Skin Diseases Are at Higher Risk of Sleep Disorders
In children aged 5 to 17 with skin disorders, researchers explore the risk of developing psychosocial comorbidities, sleep disturbances, and common related symptoms.
For children with inflammatory skin diseases, the risk of developing sleep and psychological disorders is significantly increased, according to data published in the Journal of the American Academy of Dermatology.1 Appropriate screening methods and treatment initiation are crucial for preventing mental and physical health issues for children in this population.
“The prevalence of inflammatory skin diseases in children ranges from approximately 0.1% in urticaria, to 2% in psoriasis, and up to 20% in atopic dermatitis (AD),” wrote authors of the study. “Commonly observed symptoms (ie, pruritus and pain), psychosocial comorbidities such as sleep disorders (47%-80%), and psychological disorders in adults as well as in children lead to severely impaired quality of life.”
Researchers retroactively explored patient data from children with inflammatory skin conditions between 5 and 17 years old and compared them with a control group. | image credit: candy1812 / stock.adobe.com
With researchers focusing on sleep conditions in children with inflammatory skin diseases, they presented the 3 main types of psychological sleep disorders and how they affect one another.
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The most prevalent sleep condition is insomnia, which commonly results in individuals struggling to fall or stay asleep. According to an American Academy of Sleep Medicine survey, 12% of US patients said they have been diagnosed with chronic insomnia, constituting approximately 40 million Americans.2 Sleep apnea is another common condition that obstructs airways and the central nervous system during sleep. Finally, hypersomnia is typically a product of sleep apnea or insomnia and is defined as “excessive sleepiness” influenced by other factors or conditions.
“Adults with psoriasis, urticaria, or AD have an increased risk of sleep apnea, with several causalities beside obesity, such as airway swelling or allergic rhinitis, being discussed,” they continued.1 “However, data on hypersomnia are missing and little is known about the risk association between the development of various forms of these sleep and psychological disorders in early childhood. Therefore, we aimed to retrospectively investigate the risk of developing psychosocial comorbidities, sleep disturbances, and common related symptoms in a pediatric population at the age of 5 to 17 years.”
Researchers retroactively explored patient data from children with inflammatory skin conditions between 5 and 17 years old and compared them with a control group. The 3 types of skin conditions study participants reported were either AD, psoriasis, or urticaria. These participants were then compared with the study’s control group, which included similarly aged children who reported a fracture in the upper end of their radius bone (forearm).
After identifying where to draw the study population from, researchers then analyzed participants for the next 5 years to see how likely they were to develop a variety of psychological conditions. “Outcome events analyzed consisted of diagnoses of depression, fatigue, sleep disturbance unspecified, sleep apnea, insomnia, and also pruritus and pain because of its known prevalence in all 3 skin diseases,” wrote the authors.1
In their exploration of around 98 million patients, researchers ended up matching 79,673 children with AD, 28,365 with psoriasis, and 82,452 with urticaria to the same number of individuals with fractured upper radii. Mean ages for the AD, psoriasis, and urticaria groups were 9.9, 11.7, and 10.1 years, respectively.
“In this study, it was found that diseased children had a higher risk of developing psychological comorbidities or sleep disorders. Among sleep disorders, sleep apnea had the highest overall incidence,” continued the authors.1 “Although children with psoriasis were more likely to develop hypersomnia, sleep apnea, and fatigue, children with urticaria were more likely to develop insomnia.”
While each skin disease resulted in varied risk of sleep disorders, skin conditions among children significantly resulted in negative impacts on their sleep. Across the board, all 3 sleep conditions significantly increased among children with any of the 3 aforementioned skin disorders. Indeed, sleep apnea risk increased among children with any skin condition but was the highest in children with psoriasis. While hypersomnia significantly increased among all skin disorders, the only group that experienced no significant difference in insomnia risk was those with psoriasis.
Looking forward, researchers hope that providers can use these data and facilitate better psychological and sleep-related outcomes among children with skin disorders. While these populations face their own issues with skin diseases alone, providers should be prepared to screen and treat children at high risk of developing sleep disorders as well.
“Our findings might be of particular interest for physicians to improve patient monitoring and early screening and treatment to potentially prevent onset of these comorbidities, thereby positively influencing the development into adulthood of children with inflammatory skin diseases. By raising awareness and enabling early detection and treatment, it is possible to avoid additional loss of quality of life and reduce disease burden,” they concluded.1
READ MORE: Dermatology Resource Center
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