Research Summary

High Global Prevalence of Sleep Disorders in Patients With Atopic Dermatitis

Edited by:
Kate Young

Key Highlights:

  • Meta-analysis of 32 cross-sectional studies (85,921 participants) found 43.4% of patients with atopic dermatitis (AD) experience sleep disturbances.
  • Geographic subgroup analysis revealed regional differences, with highest prevalence in Africa and lowest in South America.
  • Sleep disturbances correlated with AD severity and assessment method used.
  • Authors emphasize the need for further research to clarify underlying mechanisms.

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In a systematic review and meta-analysis published in Archives of Dermatological Research, researchers assessed the prevalence of sleep disorders in patients with atopic dermatitis across diverse geographic settings and study designs.

Sleep disturbances are a common comorbidity among patients with AD that can compound patient morbidity. In this analysis, the prevalence of sleep disturbances among individuals with AD was quantified using data pooled from English-language cross-sectional studies adhering to PRISMA guidelines.

Researchers conducted a comprehensive literature search of four major databases (EMBASE, Web of Science, PubMed, and Cochrane Library) through February 2025 to identify studies reporting quantitative data on sleep disturbances among patients with AD. Only cross-sectional studies in English providing prevalence and sample size data were included. Discrepancies in data extraction were resolved by consensus, and STATA V15.0 with a random-effects DerSimonian-Laird model was used to estimate combined prevalence and confidence intervals.

Study Findings

The meta-analysis incorporated 32 studies with a total of 85,921 individuals diagnosed with AD, spanning 20 countries across Asia, Europe, North America, South America, Africa, and Oceania. The pooled prevalence of sleep disturbances in patients with AD was 43.4% (95% CI, 39.7–47.1%), with significant heterogeneity among studies.

Subgroup analysis by region indicated variances: the highest prevalence was observed in Africa (51.8%), while South America had the lowest (23.0%). Hospital-derived populations exhibited higher sleep disturbance rates (52.7%) than community-based cohorts (36.4%). Studies published between 2016 and 2025 reported higher prevalence compared with earlier research. Assessment tools influenced prevalence estimates, with PROMIS scales yielding higher rates of sleep disturbance than PSQI- or BISQ-based measures. Severe to very severe AD was associated with higher prevalence of sleep disorders.

Insomnia was more commonly reported than somnolence, and frequencies of nocturnal awakenings further outlined sleep disruption patterns in this population.

Clinical Implications

According to the study authors, the findings highlight that sleep disturbances are common among patients with AD worldwide and vary by geography, severity of skin disease, and measurement method. The high prevalence underscores the importance of routine evaluation of sleep quality in clinical practice, especially for patients with more severe AD or those referred to hospital settings. These data may inform clinician awareness and interdisciplinary care approaches addressing both dermatologic and sleep health.

Expert Commentary

“Patients with AD have significantly higher rates of sleep disturbances compared to the general population, and a greater number of AD patients in Africa suffer from sleep disorders,” the researchers concluded. “The relationship between AD and sleep disturbances is not yet fully understood, and further research should be dedicated to exploring the link and the underlying mechanisms between the two conditions.”

Reference:
Zhang N, Chi H, Jin Q, et al. Prevalence of sleep disorders in atopic dermatitis: a systematic review and meta-analysis. Arch Dermatol Res. 2025;317:668. doi:10.1007/s00403-025-04176-0