Burden of Sleep and Fatigue in US Adults With Atopic Dermatitis

Abstract

Background: Intense itch associated with atopic dermatitis (AD) can negatively impact sleep. However, the nature of sleep disturbance and fatigue in AD has not been fully elucidated.

Objectives: The aim of this study was to determine the burden of sleep disturbance and fatigue in US adults with AD.

Methods: This study used a cross-sectional, questionnaire-based survey using a nationally representative sample of 5563 adults from the 2005 to 2006 National Health and Nutrition Examination Survey. Respondents were asked about history of AD, sleep disturbance, and fatigue-related instrumental activity of daily living (IADL) impairment.

Results: There was no significant association between having AD and having a diagnosed sleep disorder (10.44% vs 7.27%; odds ratio [OR] [95% confidence interval (CI)], 1.49 [0.84-2.64]; P = 0.23); however, respondents were more likely to report sleep disturbances to clinicians (33.38% vs 23.67%; OR [95% CI], 1.62 [1.10-2.38]; P = 0.04). In multivariate regression models controlling for sociodemographic and lifestyle factors, adults with AD had higher odds of sleep disturbances, including shorter sleep duration (adjusted OR [95% CI], 1.61 [1.16-2.25]), trouble falling asleep (adjusted OR [95% CI], 1.57 [1.10-2.24]), and early morning awakenings (adjusted OR [95% CI], 1.86 [1.24-22.78]). Those with AD also had significantly higher odds of feeling unrested and feeling too tired to perform IADLs.

Conclusions: United States adults with AD have significantly impaired sleep and fatigue affecting IADLs, and sleep disturbances may be underdiagnosed in this population.