title: Resting energy expenditure, oxygen consumption and carbon dioxide production during sleep in children with atopic dermatitis.
abstract: BACKGROUND
  Pruritus and scratching are cardinal symptoms of atopic dermatitis (AD). Sleep and growth may also be affected in children with moderate-to-severe AD. We evaluated whether resting energy expenditure (REE), oxygen consumption (VO2) and carbon dioxide production (VCO2) in various stages of sleep were influenced by the disease severity.
  
  
  METHODS
  Disease severity was evaluated by the scoring atopic dermatitis (SCORAD) index. All-night polysomnography was performed and REE, VO2 and VCO2 were measured.
  
  
  RESULTS
  Twenty children (13 boys and seven girls) with AD and eight controls were recruited. The median overall SCORAD for our AD patients was 36.8. The total sleep efficiency was lower in patients with severe AD than that obtained in the control group (median: 72% versus 88%; p = 0.039). When compared with mild-to-moderate disease (SCORAD40) and controls, REE, VO2 and VCO2 in patients with severe AD (SCORAD > 40) did not differ in sleep stages I and II combined, stages III and IV combined or the rapid eye movement (REM) stage. REE, VO2 and VCO2 in these sleep stages did not show significant correlation with the overall and the three components of the SCORAD scores.
  
  
  CONCLUSIONS
  Children with AD do not appear to have significant disturbance in their resting energy consumption, oxygen consumption and carbon dioxide production during sleep. These parameters do not appear to correlate with the symptomatology of pruritus and sleep disturbance. We speculate that deranged metabolism during sleep is unlikely in children with AD.
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China. ecohen@cuhk.edu.hk
authors.forename: K L E
authors.initials: KL
authors.lastname: Hon
authors.forename: T F
authors.initials: TF
authors.lastname: Leung
authors.forename: K C
authors.initials: KC
authors.lastname: Ma
authors.forename: A M
authors.initials: AM
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Wong
authors.forename: J A
authors.initials: JA
authors.lastname: Yin
authors.forename: T F
authors.initials: TF
authors.lastname: Fok
mesh_terms: D000293:Adolescent; D002245:Carbon Dioxide / Q000378:metabolism*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000503:physiopathology*; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology*; D017286:Polysomnography; D012720:Severity of Illness Index; D012894:Sleep Stages / Q000502:physiology; D018709:Statistics, Nonparametric
chemical_list: D002245:Carbon Dioxide