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Depressive Symptoms and Sleep Disturbance in Female Nurses with Atopic Dermatitis: The Korea Nurses' Health Study.

ABSTRACT: Although the prevalence of atopic dermatitis is high in nurses, there is a lack of research on the relationship between atopic dermatitis and depressive symptoms and sleep disturbance among female nurses. This study aimed to determine the effects of atopic dermatitis on depressive symptoms and sleep disturbance in female nurses. We analyzed the data of the Korea Nurses' Health Study, a large-scale prospective cohort study. A total of 20,613 female hospital nurses aged 20-45 years who participated in the Module 1 of Korea Nurses' Health Study between July 2013 and November 2014 were included. The chi-square test, t-test, and multivariate ordinal logistic regression analysis were conducted for statistical analysis. The prevalence of atopic dermatitis among female nurses was 11.6%. The levels of depressive symptoms and sleep disturbance were higher in nurses with atopic dermatitis than those without atopic dermatitis. Nurses with atopic dermatitis were 1.16 times more likely to have depressive symptoms and 1.35 times more likely to have sleep disturbance than those without atopic dermatitis after adjusting for confounding variables. The results of this study suggest that additional support should be considered for nurses with atopic dermatitis to improve the occupational environment for managing and preventing the exacerbation of symptoms.

SUBMITTER: Kim B

PROVIDER: S-EPMC7215983 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Depressive Symptoms and Sleep Disturbance in Female Nurses with Atopic Dermatitis: The Korea Nurses' Health Study.

Kim Bohye B Jung Heeja H Kim Jiyoung J Lee Jisun J Kim Oksoo O

International journal of environmental research and public health 20200416 8

Although the prevalence of atopic dermatitis is high in nurses, there is a lack of research on the relationship between atopic dermatitis and depressive symptoms and sleep disturbance among female nurses. This study aimed to determine the effects of atopic dermatitis on depressive symptoms and sleep disturbance in female nurses. We analyzed the data of the Korea Nurses' Health Study, a large-scale prospective cohort study. A total of 20,613 female hospital nurses aged 20-45 years who participate ...[more]

PMID: 32316146

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Project description:BackgroundAtopic dermatitis (AD) causes sleep disturbance but the epidemiology is not known.ObjectiveTo estimate the US prevalence of sleep disturbance and its impact on psychological and neurocognitive function.MethodsWe conducted a cross-sectional survey of 180 parent-child dyads with AD using stratified sampling based on disease severity (Patient Oriented Eczema Measure: mild [n = 30), moderate (n = 75) or severe (n = 75]), age, and race (White or Black or African American or other). Symptoms of sleep and psychologic health were assessed using the Patient-Reported Outcome Measurement Information System. To estimate the prevalence of sleep disturbance, we calculated weights using poststratification adjustment making marginal frequencies of AD severity, race, and age similar to marginal frequencies in the 2007 National Survey of Children's Health. Unweighted regression models examined associations with sleep disturbance.ResultsIn children age 5 to 17 years with AD, we estimated that sleep disturbance occurred in 66.9% (95% confidence interval, 53.3% to 80.5%; 3,116,305 children). The odds of severe sleep disturbance (worse than 95% of US children) were highest in moderate to severe versus mild AD (2.03 [1.00-4.10]; P = .0495; compared with 8.68 [1.82-41.49]; P = .0068). Predictors of parent proxy-reported sleep disturbance were itch intensity (adjusted β [95% confidence interval] 1.33 [0.62-2.04]) and low income (<$50,000: 6.64 [2.05-11.23]; and $50,000 to less than 100,000: 4.75 [0.35-9.14]). Controlling for disease severity, itch intensity, and significant sociodemographics-parent-proxy, reported sleep disturbance was associated with increased severity of sleep-related impairment, depression, fatigue, and anxiety, in addition to worse inattention and impulsivity. In fully adjusted models, children who self-reported sleep disturbance (T-score ≥60) had increased odds of sleep-related impairment (1.20 [1.11-1.29]), depression (1.13 [1.03, 1.24]), fatigue (1.28 [1.06-1.54]), and anxiety (1.16 [1.02-1.31]).ConclusionsSleep disturbance is a common symptom of AD. It affects about 3 million US children and is associated with neuropsychiatric impairment, including depression, anxiety, and inattention. Clinicians should screen for these symptoms in school-aged children, particularly those with moderate to severe AD.

Project description:ImportancePruritus, a hallmark of atopic dermatitis (AD), is thought to disrupt sleep, yet little is known about how variations in disease activity and severity of this common childhood condition may be associated with sleep patterns over time.ObjectiveTo determine whether children with active AD have impaired sleep duration and quality at multiple time points throughout childhood and whether disease severity affects sleep outcomes.Design, setting, and participantsThis longitudinal cohort study used data of children enrolled in the Avon Longitudinal Study of Parents and Children, a population-based birth cohort in Avon, United Kingdom. Participants were children (N = 13 988) alive at 1 year and followed up with repeated measures of self-reported AD and sleep through 16 years of age. This study was based on data collected from 1990 to 2008. Data analysis was performed from September 2017 to September 2018.Main outcomes and measuresStandardized measure of sleep duration and composite measure of sleep quality, including nighttime awakenings, early morning awakenings, difficulty falling asleep, and nightmares, were repeated at multiple time points between 2 and 16 years of age.ResultsThe study sample comprised 13 988 children (7220 male [51.6%]) followed up for a median (interquartile range [IQR]) duration of 11 (5-14) years. Of this total, 4938 children (35.3%) met the definition of having atopic dermatitis between 2 and 16 years of age. Total sleep duration was similar between children with active AD and without AD at all ages, and the average estimated difference across childhood was a clinically negligible difference of 2 minutes less per day for children with AD (95% CI, -4 to 0 minutes). In contrast, children with active AD were more likely to report worse sleep quality at all time points, with a nearly 50% higher odds of experiencing more sleep-quality disturbances (adjusted odds ratio [aOR], 1.48; 95% CI, 1.33 to 1.66). Children with more severe active disease (quite bad or very bad AD: aOR, 1.68; 95% CI, 1.42 to 1.98) and with comorbid asthma or allergic rhinitis (aOR, 1.79; 95% CI, 1.54 to 2.09) had worse sleep quality. However, even children with mild AD (OR, 1.40; 95% CI, 1.27 to 1.54) or inactive AD (OR, 1.41; 95% CI, 1.28 to 1.55) had statistically significantly increased odds of impaired sleep quality.Conclusions and relevanceAtopic dermatitis appeared to be associated with impaired sleep quality throughout childhood; thus, it is suggested that clinicians should consider sleep quality among all children with AD, especially those with comorbid asthma or allergic rhinitis and severe disease, and that interventions to improve sleep quality are needed.

Dataset Information

Depressive Symptoms and Sleep Disturbance in Female Nurses with Atopic Dermatitis: The Korea Nurses' Health Study.

Publications

Depressive Symptoms and Sleep Disturbance in Female Nurses with Atopic Dermatitis: The Korea Nurses' Health Study.

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