Children with inflammatory skin diseases at higher risk for sleep, psychological disorders

Key takeaways:

• Children with atopic dermatitis, psoriasis or urticaria are much more likely to develop sleep and psychological disorders.
• The include hypersomnia, sleep apnea, depression, anxiety and more.

Children with inflammatory skin diseases are at an increased risk for sleep and psychological disorders, prompting clinicians to consider the broader effects of skin disease and how to address them, according to a study.

Published in the Journal of the American Academy of Dermatology, the study highlighted something “dermatologists and families often see firsthand,” Danilo Del Campo, MD, FAAD, a dermatologist at the Chicago Skin Clinic who was unaffiliated with the study, told Healio.

“Inflammatory skin conditions in children do not just affect the skin,” Del Campo said. “They can disrupt sleep, impact mood and take a toll on overall quality of life.”

Using data from the United States Collaborative Network, the study evaluated the outcomes of patients aged 5 to 17 years with a diagnosis of AD (n = 79,673), psoriasis (n = 28,365) or urticaria (n = 82,452).

Results showed children with psoriasis were 3.2 times more likely to develop hypersomnia, 2.1 times more likely to develop sleep apnea, 1.8 times more likely to develop fatigue and 1.9 times more likely to develop depression.

Similarly, children with urticaria and AD had a 1.7-fold, 1.6-fold and 1.4-fold higher risk for sleep disorders, anxiety disorders and insomnia, respectively. Children with AD alone were 1.5 times more likely to develop an anxiety disorder.

According to Del Campo, children experiencing short-term sleep loss will exhibit signs of irritability, attention difficulties and mood swings. If the lack of sleep continues, affected children can experience anxiety, depression and even academic challenges.

“Childhood is a critical window for emotional and physical development, so sleep disturbances caused by skin discomfort should be taken seriously,” Del Campo said. “Fortunately, many of these effects can improve when both the skin and sleep are addressed together.”

When it comes to addressing the skin, Del Campo advises that dermatologists ask pediatric patients and their family members leading questions about sleep to evaluate whether the current treatment regimen is effective. Asking questions such as ’Are nights difficult?,’ ’Does your child wake up scratching?’ and similar inquiries may uncover issues that would otherwise go unaddressed.

“We need to ask about sleep when managing chronic skin conditions in children,” Del Campo said. “If a child is not sleeping well due to itching or discomfort, that is an important clinical sign that treatment may need to be modified.”

When treating sleep loss specifically, Del Campo recommends involving sleep experts and other specialists versed in pediatric wellness. However, he also highlighted a few sleep hygiene tips that dermatologists can recommend to their patients. These include sleeping at the same time each night, making sure the room is dark, limiting distractions, removing blue light-emitting devices from the room and finding ways to relax.

“Restful sleep is not a side goal,” Del Campo said. “It is a vital part of managing these conditions effectively.”

For more information:

Danilo Del Campo, MD, FAAD, can be reached at info@chicagoskinclinic.com or on Instagram @ChicagoSkinClinic.