Abstract
BACKGROUND: Most children with atopic dermatitis (AD) experience sleep disturbance, but reliable and valid assessment tools are lacking. OBJECTIVES: To test the Patient-Reported Outcomes Measurement Information System (PROMIS) 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 children with AD ages 5 to 17 years and 1 parent (n = 61), who completed sleep, itch, and AD-specific questionnaires; clinicians assessed disease severity. All children wore actigraphy watches for a 1-week objective sleep assessment. RESULTS: PROMIS sleep disturbance parent proxy reliability was high (Cronbach α = 0.90) and was differentiated among Patient-Oriented Eczema Measure (POEM)-determined disease severity groups (mean ± standard deviation in mild vs moderate vs severe was 55.7 ± 7.5 vs 59.8 ± 10.8 vs 67.1 ± 9.5; P < .01). sleep disturbance correlated with itch (numeric rating scale, r =" 0.48)," promis sleep-related impairment (r =" 0.57)," and worsened quality of life (children's dermatology life quality index, r =" 0.58)," with all p values less than .01. positive report on the 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.>
