Disease severity, scratching, and sleep quality in patients with atopic dermatitis

Background: The relationship between sleep quality and disease severity in patients with atopic dermatitis has not been clearly defined. Methods: Sleep efficiency and scratching were measured over 2 nights by polysomnography, actigraphy, and self-report in 20 adults with atopic dermatitis. Tumor necrosis factor, interleukin (IL)-6, and IL-10 were assayed from a subset of 9 participants. Results: Sleep measured by actigraphy and polysomnography were strongly associated with each other. Decreased sleep efficiency was associated with increasing disease severity, scratching, and IL-6. Self-reported sleep quality and quality of life were not significantly correlated with either objective sleep measure. Limitations: Results in this pilot study await confirmation in a larger investigation. Conclusion: Objective measures but not self-report documented that increasing severity of atopic dermatitis results in more scratching and declining sleep quality. Our data also suggest an important relationship between sleep and IL-6.