Mechanism of Sleep Disturbance in Children with Atopic Dermatitis and the Role of the Circadian Rhythm and Melatonin

The 2016 review explored the complex relationship between atopic dermatitis (AD) and sleep disturbances in children, focusing on the roles of circadian rhythm and melatonin. It was reported that 47%-60% of children with AD experience sleep disturbances, which significantly affect their quality of life. The review suggested that pruritus and scratching are major factors disrupting sleep, but also highlighted the potential influence of circadian rhythm on cytokine production and immune function. Melatonin, which regulates sleep and circadian rhythm, may also play a role due to its immunomodulatory and antioxidant properties. A study involving 72 children with AD and 32 healthy controls found that higher nocturnal melatonin levels correlated with better sleep efficiency and milder AD. Furthermore, a trial with 3 mg of oral melatonin given to children aged 1 to 18 years before bedtime for four weeks showed improvements in AD severity and reduced sleep onset latency. The review emphasized the need for more research to fully understand the interplay between AD, sleep, cytokines, and melatonin, and to develop effective treatments for sleep issues in children with AD.