Actigraphy assessment of sleep disturbance in patients with atopic dermatitis: An objective life quality measure

Background: Patients with atopic dermatitis (AD) frequently report compromised quality of life because of disturbed sleep and daytime fatigue secondary to their skin disease, but few studies provide objective measurement of sleep change in this population. Objective: The purpose of this investigation was to contrast subjective and objective measures of sleep quality in patients with AD. Methods: Fourteen adult patients with AD and 14 adult control subjects with no skin disease wore actigraphs; for 1 week and completed questionnaires about sleep, itch, and quality of life. Results: As measured by self-report and actigraphy, the AD group slept more poorly and reported more daytime fatigue than the control group. Actigraphy alone was correlated with itch and quality of life and was able to discriminate movement during sleep, number of awakenings, minutes asleep, and minutes awake. Conclusions: Results from this study demonstrate that sleep is significantly compromised in patients with AD. Patients' perception of their sleep provides less detail and accuracy than actigraphy. The actigraph is an objective, unobtrusive measure of sleep at home in patients with skin disease and can provide an important outcome measure in clinical trials.