Anna B Fishbein1, Jennifer Lor2, Frank J Penedo3, Christopher B Forrest4, James W Griffith5, Amy S Paller6. 1. Department of Pediatrics, Division of Pediatric Allergy & Immunology, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago IL, USA. Electronic address: afishbein@luriechildrens.org. 2. Department of Pediatrics, Division of Pediatric Allergy & Immunology, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago IL, USA. 3. Department of Psychology, University of Miami Sylvester Comprehensive Cancer Center, Miami FL, USA. 4. Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia PA, USA. 5. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago IL, USA. 6. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago IL, USA.
Abstract
BACKGROUND: Most children with atopic dermatitis(AD) suffer from sleep disturbance, but reliable and valid assessment tools are lacking. OBJECTIVES: To test PROMIS (Patient Reported Outcomes Measurement Information System) sleep measures in pediatric AD and to develop an algorithm to screen, assess and intervene to reduce sleep disturbance. METHODS: A cross-sectional study was conducted with AD children ages 5-17 years and one parent(n=61), who completed sleep, itch, and AD-specific questionnaires; clinicians assessed disease severity. All children wore actigraphy watches for 1-week-objective sleep assessment. RESULTS: PROMIS sleep disturbance parent-proxy-reliability was high (Cronbach's α=0.90) and differentiated among Patient Oriented Eczema Measure (POEM)-determined disease severity groups (mean±SD in mild vs. moderate vs. severe was 55.7±7.5 vs. 59.8±10.8 vs. 67.1±9.5, p<0.01). Sleep disturbance correlated with itch (Numerical Rating Scale/NRS, r=0.48), PROMIS sleep-related impairment (r=0.57), and worsened quality of life (Children's Dermatology Life Quality Index/CDLQI, r=0.58), all p<0.01. Positive report on POEM sleep disturbance question has high sensitivity (95%) for PROMIS parent-proxy-reported sleep disturbance (T-score ≥60). An algorithm for screening and intervening on sleep disturbance was proposed. LIMITATIONS: This was a local sample. CONCLUSIONS: Sleep disturbance in pediatric AD should be screened using the POEM sleep question, with further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if needed.
BACKGROUND: Most children with atopic dermatitis(AD) suffer from sleep disturbance, but reliable and valid assessment tools are lacking. OBJECTIVES: To test PROMIS (Patient Reported Outcomes Measurement Information System) sleep measures in pediatric AD and to develop an algorithm to screen, assess and intervene to reduce sleep disturbance. METHODS: A cross-sectional study was conducted with ADchildren ages 5-17 years and one parent(n=61), who completed sleep, itch, and AD-specific questionnaires; clinicians assessed disease severity. All children wore actigraphy watches for 1-week-objective sleep assessment. RESULTS: PROMIS sleep disturbance parent-proxy-reliability was high (Cronbach's α=0.90) and differentiated among Patient Oriented Eczema Measure (POEM)-determined disease severity groups (mean±SD in mild vs. moderate vs. severe was 55.7±7.5 vs. 59.8±10.8 vs. 67.1±9.5, p<0.01). Sleep disturbance correlated with itch (Numerical Rating Scale/NRS, r=0.48), PROMIS sleep-related impairment (r=0.57), and worsened quality of life (Children's Dermatology Life Quality Index/CDLQI, r=0.58), all p<0.01. Positive report on POEM sleep disturbance question has high sensitivity (95%) for PROMIS parent-proxy-reported sleep disturbance (T-score ≥60). An algorithm for screening and intervening on sleep disturbance was proposed. LIMITATIONS: This was a local sample. CONCLUSIONS:Sleep disturbance in pediatric AD should be screened using the POEM sleep question, with further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if needed.
Authors: Nina Y Zhou; Amanda Nili; Courtney K Blackwell; Nonye Ogbuefi; Peter Cummings; Jin-Shei Lai; James W Griffith; Amy S Paller; Lauren S Wakschlag; Anna B Fishbein Journal: Pediatr Dermatol Date: 2021-12-21 Impact factor: 1.997
Authors: Anna B Fishbein; Brian T Cheng; Caroline C Tilley; Wendy Smith Begolka; Adam C Carle; Christopher B Forrest; Phillis C Zee; Amy S Paller; James W Griffith Journal: J Allergy Clin Immunol Pract Date: 2021-05-12
Authors: Trisha Kaundinya; Uros Rakita; Armaan Guraya; Donna Maria Abboud; Emily Croce; Jacob P Thyssen; Andrew Alexis; Jonathan I Silverberg Journal: J Invest Dermatol Date: 2021-08-02 Impact factor: 8.551