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Development of atopic disease and disturbed sleep in childhood and adolescence – a longitudinal population-based study

Authors

  • S. Jernelöv,

    Corresponding author
    • Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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    • These authors contributed equally to this study.
  • M. Lekander,

    1. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
    2. Stress Research Institute, Stockholm University, Stockholm, Sweden
    3. OsherCenter for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
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    • These authors contributed equally to this study.
  • C. Almqvist,

    1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
    2. Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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  • J. Axelsson,

    1. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
    2. Stress Research Institute, Stockholm University, Stockholm, Sweden
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  • H. Larsson

    1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
    2. Karolinska Institutet center of Neurodevelopmental Disorders, Stockholm, Sweden
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Correspondence:

Susanna Jernelöv, Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychology, SE-171 77 Stockholm, Sweden. E-mail: Susanna.jernelov@ki.se

Summary

Background

Both atopic diseases and sleep disturbances have increased during recent decades, especially in children. Sleep is important for many aspects of immune regulation relevant in allergic diseases, and sleep disturbances are common in patients with such diseases. A connection between sleep disturbances and fatigue, and atopic disease is well established. However, the time course and putative causal relationships between these factors are obscure.

Objective

We aimed at investigating the developmental relationships between subjectively reported sleep disturbances and symptoms of atopic disease, from childhood to adolescence.

Methods

This longitudinal study used parent-report questionnaire data on symptoms of atopic disease, and sleep disturbances, from the Twin Study of Child and Adolescent Development (TCHAD). Overall, 1480 twin pairs born in Sweden were approached first when children were 8–9 years old, and again later at 13–14 years old. Response rates were 75% and 72%. Data from the TCHAD questionnaires were linked to the Swedish Medical Birth Register based on personal identification numbers.

Results

Being overtired at age 8 increased the risk [OR; 95% CI (2.59; 1.31–5.11)] to develop rhinitis symptoms at age 13, even when controlling for gender, previous rhinitis, Socio-economic status, birth weight and other sleep disturbances at age 8. Likewise, symptoms of asthma at age 8 was an independent risk factor for being overtired at age 13 [OR; 95% CI (2.64; 1.44–4.84)], controlling for similar confounders.

Conclusion & Clinical Relevance

The findings from this study are consonant with the proposition that atopic disease and disturbed sleep are more than passively interrelated. Future research needs to delineate whether causal relationships between these problems are at hand and, if so, at what periods in development this applies. These results point to a need for clinicians to investigate sleep difficulties and treat impaired sleep in paediatric patients with atopic disease.

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