title: Development of atopic disease and disturbed sleep in childhood and adolescence--a longitudinal population-based study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Susanna.jernelov@ki.se
authors.forename: S
authors.initials: S
authors.lastname: Jernelöv
authors.forename: M
authors.initials: M
authors.lastname: Lekander
authors.forename: C
authors.initials: C
authors.lastname: Almqvist
authors.forename: J
authors.initials: J
authors.lastname: Axelsson
authors.forename: H
authors.initials: H
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000150:complications / Q000453:epidemiology; D002648:Child; D004485:Eczema / Q000150:complications / Q000453:epidemiology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications* / Q000453:epidemiology; D008137:Longitudinal Studies; D015995:Prevalence; D012220:Rhinitis / Q000150:complications / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000453:epidemiology