Atopic Dermatitis and Excessive Daytime Sleepiness: Analysis of Data from 8362 Adult Subjects in a Sub-Saharan Africa Country
American Journal of Internal Medicine
Volume 7, Issue 5, September 2019, Pages: 127-131
Received: Sep. 8, 2019;
Accepted: Sep. 26, 2019;
Published: Oct. 11, 2019
Views 80 Downloads 12
Eric Walter Pefura-Yone, Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon; Pneumology A Service, Yaounde Jamot Hospital, Yaounde, Cameroon
Adamou Dodo Balkissou, Faculty of Medicine and Biomedical Sciences of Garoua, University of Ngaoundéré, Garoua, Cameroon
Amadou Djenabou, Approved Treatment Center for HIV, Yaounde Jamot Hospital, Yaounde, Cameroon
Virginie Poka-Mayap, Approved Treatment Center for HIV, Yaounde Jamot Hospital, Yaounde, Cameroon
Christopher Kuaban, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
Follow on us
Sleep disorders in patients with atopic dermatitis (AD) are common and can have a negative impact on the quality of life of the affected subjects. Very little data are available on the association between AD and excessive daytime sleepiness (EDS) in adults. The objective of this study was to compare the prevalence of EDS in subjects with AD and those without AD, and to investigate the determinants of EDS in adults with AD. In this cross-sectional population-based study conducted from 2015 to 2018 in Cameroon, adult subjects aged at least 19 years were included by multi-level stratified random sampling. AD was defined as the presence of a chronic itchy dermatitis evolving intermittently over a period of at least 6 months and electively affecting certain areas (fronts of the elbows, back of the knees, front of the ankles, under the buttocks, around the neck, around the eyes or ears) during the last 12 months preceding the survey. EDS was defined by an Epworth score≥10. Logistic regression was used to investigate the independent association between EDS and AD. A difference was considered significant if p<0.05. A total of 8362 subjects (55.2% women) with median age (25th-75th percentiles) of 39 (27-54) years were included. There were 217 subjects (2.6%) with AD and 1022 subjects (12.2%) with EDS. The prevalence of EDS was higher in subjects with AD than in those without AD (22.1% vs. 12%, p<0.001). In multivariate analysis integrating potential confounders (area of recruitment, age, education level, body mass index, association with other allergic diseases), AD remained independently associated with EDS with an adjusted odds ratio (95% CI) of 2.18 (1.54-3.08). No independent associated factors to EDS were found in subjects with AD. There is an independent association between EDS and AD, and nearly one quarter of patients with AD has EDS in this setting. It is necessary to consider the systematic evaluation of EDS in subjects with AD to optimize their management.
Atopic Eczema, Dermatitis, Daytime Sleepiness, Sleep Disorders, Africa
To cite this article
Eric Walter Pefura-Yone,
Adamou Dodo Balkissou,
Atopic Dermatitis and Excessive Daytime Sleepiness: Analysis of Data from 8362 Adult Subjects in a Sub-Saharan Africa Country, American Journal of Internal Medicine.
Vol. 7, No. 5,
2019, pp. 127-131.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Chiesa Fuxench ZC, Block JK, Boguniewicz M, et al. Atopic Dermatitis in America Study: A Cross-Sectional Study Examining the Prevalence and Disease Burden of Atopic Dermatitis in the US Adult Population. J Invest Dermatol 2019; 139: 583–90. doi: 10.1016/j.jid.2018.08.028.
Theodosiou G, Montgomery S, Metsini A, et al. Burden of Atopic Dermatitis in Swedish Adults: A Population-based Study. Acta Derm Venereol Published Online First: 2019. doi: 10.2340/00015555-3257.
Drucker AM, Wang AR, Li W-Q, et al. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol 2017; 137: 26–30. doi: 10.1016/j.jid.2016.07.012.
Jeon C, Yan D, Nakamura M, et al. Frequency and Management of Sleep Disturbance in Adults with Atopic Dermatitis: A Systematic Review. Dermatol Ther (Heidelb) 2017; 7: 349–64. doi: 10.1007/s13555-017-0192-3.
Sagaspe P, Taillard J, Bayon V, et al. Sleepiness, near-misses and driving accidents among a representative population of French drivers. J Sleep Res 2010; 19: 578–84. doi: 10.1111/j.1365-2869.2009.00818.x.
Garbarino S, Guglielmi O, Sanna A, et al. Risk of Occupational Accidents in Workers with Obstructive Sleep Apnea: Systematic Review and Meta-analysis. Sleep 2016; 39: 1211–8. doi: 10.5665/sleep.5834.
Pefura-Yone EW, Kengne AP, Balkissou AD, et al. Prevalence of Asthma and Allergic Rhinitis among Adults in Yaounde, Cameroon. PLoS One 2015; 10: e0123099. doi: 10.1371/journal.pone.0123099.
Lydia Gisle SD. Enquête de santé 2013. rapport 2: comportement de santé et style de vie. https://his.wiv-isp.be/fr/Documents partages/AL_FR_2013.pdf.
Asher MI, Keil U, Anderson HR, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J 1995; 8: 483–91. doi: 10.1183/09031936.95.08030483.
Burney PG, Luczynska C, Chinn S, et al. The European Community Respiratory Health Survey. Eur Respir J 1994; 7: 954–60. http://www.ncbi.nlm.nih.gov/pubmed/8050554 (accessed 22 Mar2015).
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14: 540–5. doi: 10.1093/sleep/14.6.540.
Doneh B. Epworth Sleepiness Scale. Occup Med (Lond) 2015; 65: 508. doi: 10.1093/occmed/kqv042.
Silverberg JI, Garg NK, Paller AS, et al. Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study. J Invest Dermatol 2015; 135: 56–66. doi: 10.1038/jid.2014.325.
Li JC, Fishbein A, Singam V, et al. Sleep Disturbance and Sleep-Related Impairment in Adults with Atopic Dermatitis: A Cross-sectional Study. Dermat contact, atopic, Occup drug; 29: 270–7. doi: 10.1097/DER.0000000000000401.
Gupta MA, Gupta AK. Sleep-wake disorders and dermatology. Clin Dermatol; 31: 118–26. doi: 10.1016/j.clindermatol.2011.11.016.
Chang Y-S, Chiang B-L. Mechanism of Sleep Disturbance in Children with Atopic Dermatitis and the Role of the Circadian Rhythm and Melatonin. Int J Mol Sci 2016; 17: 462. doi: 10.3390/ijms17040462.
Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology 1993; 186: 23–31. doi: 10.1159/000247298.
Yano C, Saeki H, Ishiji T, et al. Impact of disease severity on sleep quality in Japanese patients with atopic dermatitis. J Dermatol Sci 2013; 72: 195–7. doi: 10.1016/j.jdermsci.2013.06.010.
Maugeri A, Medina-Inojosa JR, Kunzova S, et al. Sleep Duration and Excessive Daytime Sleepiness Are Associated with Obesity Independent of Diet and Physical Activity. Nutrients 2018; 10. doi: 10.3390/nu10091219.
Lee Y, Kanagasabai T, Rigobon A V, et al. Depressive symptom severity mediates the association between sleep disturbance and obesity in US adults: Results from the NHANES. Ann Clin Psychiatry 2019; 31: 111–22. http://www.ncbi.nlm.nih.gov/pubmed/31046032.
Manzar MD, Salahuddin M, Alamri M, et al. Psychometric properties of the Epworth sleepiness scale in Ethiopian university students. Health Qual Life Outcomes 2019; 17: 30. doi: 10.1186/s12955-019-1098-9.