Itchy skin associated with sleep problems in infants

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A recent study presented at the American Academy of Pediatrics 2024 National Conference & Exhibition sheds light on the connection between skin conditions and sleep disturbances in infants and toddlers, highlighting itchy skin as a significant factor, even without atopic dermatitis (AD).

The research, which surveyed 300 mothers of infants aged 0 to 11.9 months, aimed to explore how allergic skin conditions, including AD, impact sleep quality.

Methods

The study used an online questionnaire, administered at 3 time points: baseline, 4 months later (first follow-up, FU1), and 8 months after baseline (second follow-up, FU2). Mothers were asked to report on their child’s sleep and skin conditions, such as AD, itchy skin, dry or flaky skin, and food allergies. The researchers compared the prevalence of allergic skin conditions in children with and without parent-reported sleep problems at each follow-up, using chi-square analysis.

Results

At the start of the study, 29.3% of parents reported sleep problems in their infants, a figure that remained relatively stable at FU1 (29.6%) but dropped to 23.5% at FU2. About 29% of the infants were reported to have some form of skin condition, including AD, itchy, dry, or flaky skin.

One of the study’s key findings was the strong association between itchy skin and sleep difficulties. At baseline, 38.6% of infants with itchy, dry, or flaky skin had sleep problems, compared to only 25.0% of infants without such skin issues. This correlation persisted throughout the study, with 11.3% of infants and toddlers with itchy skin at FU1 and FU2 experiencing sleep problems, compared to just 3.0% and 2.3%, respectively, of those without itchy skin.

Interestingly, the study also revealed that the vast majority of children who were reported to have itchy skin did not have a formal diagnosis of AD. At FU1, 90% of infants with itchy skin were not reported to have AD, and at FU2, this figure was 87%. This suggests that itchy skin alone, independent of other skin conditions like AD, plays a significant role in sleep disruption.

Implications

The study’s authors emphasize the importance of addressing itchy skin in pediatric assessments, even when AD is not diagnosed. "Pediatricians are encouraged to assess for itchy skin and its associated sleep problems, even if a child does not meet criteria for atopic dermatitis," concluded the study authors. While AD has traditionally been seen as a major contributor to sleep issues, this research highlights the need to consider other skin symptoms, particularly itchiness, when evaluating infant and toddler sleep difficulties.

With 29% of infants experiencing sleep problems at some point during the study, addressing skin-related discomfort could provide relief to many families. The researchers recommend further studies to better understand the mechanisms linking itchy skin to disrupted sleep and explore potential interventions.

Conclusion

This study brings new attention to the role of skin conditions in infant sleep, particularly the underappreciated role of itchy skin. While atopic dermatitis has long been linked to sleep issues, these findings suggest that itchy skin without AD can also lead to significant sleep disturbances, urging health care professionals to broaden their focus in both diagnosis and treatment.

Reference:

Leichman ES, Mindell JA, Gould R, Mack MC, Carson M. Sleep problems and allergic skin conditions in infants and toddlers. Presented at: American Academy of Pediatrics 2024 National Conference & Exhibition. September 27-October 1, 2024. Orlando, Florida.