Infantile atopic dermatitis and sleep in the first two years of life in a contemporary cohort study

Summary: Abstract Body: Atopic dermatitis (AD) is often associated with poor sleep, but many infants/toddlers without AD also have poor sleep. Poor infant sleep places a high burden on parents and can lead to establishment of unhealthy sleep patterns. We aimed to examine the association between AD and sleep in the first 2 years of life within a contemporary multinational cohort. The NiPPeR double-blind randomised trial recruited 1729 UK, Singapore & New Zealand women planning a pregnancy. Participants were allocated to a control (standard micronutrients (folic acid, iodine, calcium, β-carotene, iron) or an intervention supplement (additionally including vitamins D, B2, B6, B12, zinc, myo-inositol, probiotics (L.rhamnosus, B.animalis)). Infant/toddler sleep was assessed using the nurse-led, validated, Brief Infant Sleep Questionnaire (BISQ) at ages 3 & 6 weeks & 3, 6, 12 & 24 months, allowing derivation of the number of awakenings and wake duration after night sleep onset, night sleep duration and day sleep. 553 offspring were assessed at ages 6 and 12 months; AD prevalences (trial secondary outcome, modified UK Working Party Diagnostic Criteria) were 10.8% and 13.0%, respectively. Night time sleep and number of awakenings were similar in infants with AD and those who did not have AD. Infants with/without AD had similar sleep trajectories adjusting for site, sex and breastfeeding (regression analyses examining AD at 6 and 12 months in relation to night sleep at the different timepoints were not significant (p>0.05)). It is encouraging that no associations were seen in our longitudinal data, perhaps due to effective management of AD. This supports guidance for optimisation of AD treatment to minimise effects on infant sleep. Sarah El-Heis^{1, 2}, Philip Titcombe¹, Sheila Barton¹, Elizabeth Huiwen Tham³, Benjamin Albert⁵, Shiao-Yng Chan^{3, 4}, Wayne Cutfield⁵, Keith Godfrey^{1, 2} 1. University of Southampton MRC Lifecourse Epidemiology Centre, Southampton, England, United Kingdom. 2. NIHR Southampton Biomedical Research Centre, Southampton, England, United Kingdom. 3. Singapore Institute of Technology, Singapore, Singapore. 4. Department of Obstetrics and Gynaecology, National University of Singapore Yong Loo Lin School of Medicine, Singapore, Singapore. 5. The University of Auckland Liggins Institute, Auckland, Auckland, New Zealand. Clinical Research: Epidemiology and Observational Research