Healthy Sleep for Atopic Dermatitis

One of the chief ways to promote healthy sleep in children with atopic dermatitis is to treat nighttime pruritus.

In addition to reducing itch, encouraging appropriate sleep patterns can assist in improving quality of life for the child and family. Lack of sleep is associated with

• Depression
• Obesity
• Poor school performance
• Behavior problems

In particular, adolescents with poor sleep appear to be more at risk for

• Inattention and reduced motivation
• Drowsy driving
• Affective dysregulation
• Drug and alcohol use
• Suicidal ideation

The recommended hours of sleep per day to promote optimal health are

• Infants 4 to 12 months of age: 12 to 16 hours (including naps)
• Children 1 to 2 years of age: 11 to 14 hours (including naps)
• Children 3 to 5 years of age: 10 to 13 hours (including naps)
• Children 6 to 12 years of age: 9 to 12 hours
• Teenagers 13 to 18 years of age: 8 to 10 hours

Educate Parents on Sleep Hygiene

The following general principles of sleep hygiene apply at any age, but specifics may vary with the child’s age:

• Establish a good sleep environment that is dark, quiet, and comfortable and has a steady, slightly cool temperature. Sleep should be in the same place for night and naps as much as possible. The bed or crib should be used as a place for sleep and not as play area or playpen while awake.
• Establish a soothing bedtime routine that involves friendly interaction between the parent and child. This routine may include a snack and then toothbrushing, use of the toilet, and story or talking time with children in their own bed. The parent should leave the room while the child is still awake.
• Infants should be fed in a parent’s arms and placed in the crib without a bottle in their mouth. Avoid excessive feeding close to bedtime to reduce the need to void during the night.
• The child should be put to bed when moderately tired to reduce bedtime resistance.
• For infants whom the parents would like to have sleep in their own crib, teach them the skill of falling asleep on their own by avoiding pacifiers or body contact with the parent as they drift to sleep (self-soothing). This method enables infants to go back to sleep on their own after waking during the night.
• Avoid changing the routine because of demands or tantrums at bedtime, which can quickly develop into a pattern.
• No television, computer, or any electronic screens should be in the child’s room. Research shows that video screens prolong sleep onset and delay bedtime. It is advisable to enforce an electronic curfew for older children and adolescents to facilitate preparation for sleep without distraction and also prevent further use during the night without parental supervision.
• Try to keep a consistent schedule for bedtime, naps, and morning wake-up, which will help the child maintain regular circadian rhythms. Naps should not be taken too close to bedtime.
• Remember that television programs and movies may be frightening or stimulating. Arguments between parents or other family members may also be distressing. Try to keep the household atmosphere calm in the evening.
• Keep track of activities that seem to lead to sleeping problems. If active play or video games lead to problems, stop them 1 or 2 hours before bedtime. Caffeine and nicotine can disrupt sleep. Avoid caffeine at least 6 hours before bedtime.
  
  

The development of this information was made possible through support from Sanofi and Regeneron.