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Volume 15 No. 08
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Accepted Papers





Scientific Investigations

Sleep and Limb Movement Characteristics of Children With Atopic Dermatitis Coincidentally Undergoing Clinical Polysomnography

Alison D. Treister, BS, BSHS1,2; Heather Stefek, BA1,2; Daniela Grimaldi, MD, PhD3,4; Neil Rupani1,2; Phyllis Zee, MD, PhD3,4; Jeremy Yob, MS5; Stephen Sheldon, DO5; Anna B. Fishbein, MD2
1Feinberg School of Medicine, Northwestern University, Chicago, Illinois;; 2Department of Allergy, Division of Pediatric Allergy and Immunology, Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois;; 3Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;; 4Center for Circadian and Sleep Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;; 5Department of Pediatrics, Division of Pulmonology, Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois; *Co-first author, contributed equally

Study Objectives:

Atopic dermatitis (AD) is a prevalent, chronic, itchy skin condition. Children undergoing polysomnography (PSG) may coincidentally have AD. Many children with AD have sleep disturbances. Our study aimed to characterize limb movements in children with AD and their effect on sleep.

Methods:

A retrospective chart review was conducted for children who underwent comprehensive attended PSG and had AD. PSG sleep parameters were compared to published normative data. A subset of patients with markedly elevated total limb movements was further compared to a matched group of patients with a diagnosis of periodic limb movement disorder (PLMD) and no history of AD.

Results:

There were 34 children with AD 6.36 ± 3.21 years (mean ± standard deviation), 50% female and with mild to moderate AD. There was increased wake after sleep onset (WASO = 46.0 ± 37.8 minutes), sleep onset latency (46.5 ± 53.0 minutes) and total limb movement index (13.9 ± 7.5 events/h) compared to normative values. Although our cohort was mostly mild AD, 7 of the 34 children with AD (20%) had a total limb movement index during sleep > 15 events/h. Increased total limb movements in PLMD versus patients with AD was most notable during stage N2 sleep (38 ± 17 versus 22 ± 7, P = .01, respectively).

Conclusions:

We found altered PSG parameters in children with AD, suggesting that clinicians should consider the diagnosis when affected children undergo PSG. Although our AD cohort was mild, we still determined a need to consider AD when diagnosing PLMD given the presence of elevated total limb movements in children with AD.

Citation:

Treister AD, Stefek H, Grimaldi D, Rupani N, Zee P, Yob J, Sheldon S, Fishbein AB. Sleep and limb movement characteristics of children with atopic dermatitis coincidentally undergoing clinical polysomnography. J Clin Sleep Med. 2019;15(8):1107–1113.




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