Eczema

Eczema often starts before the age of two, and affected babies may develop poor sleep habits early. Eczema persists into adolescence or adulthood in around 30 per cent of cases, meaning that people with eczema can suffer with itchy skin and disturbed sleep for large parts of their lives.

Poor quality sleep affects memory, concentration and mood, and in healthy children and young people, poor quality sleep has been associated with poorer educational outcomes.

Crucially, in children and young people with eczema, those without sleep disturbance do not have a significantly higher risk of ADHD than the general population, whereas for children and young people with eczema and sleep disturbance, the chance of having ADHD is 40-50 per cent higher than those without eczema. This suggests that sleep disturbance itself can be associated with psychological and cognitive difficulties.

However, researchers do not fully understand the links between eczema, itching and mental health issues. Professor Flohr and colleagues propose that chronic inflammation in the skin and blood, leading to sleep disturbance and inflammation in the brain, are likely to be important drivers of these mental health issues.

To test this theory, Professor Flohr will study patients aged 12-18 from the Paediatrics Severe Eczema Clinic at St Thomas’ Hospital and King’s College London, comparing adolescents with eczema to healthy adolescents, and to children and young people with ADHD.

The researchers will investigate whether brain structure and function, and thought processes, are affected by sleep disturbance and inflammation. This includes assessments using sleep diaries and gadgets, measurements of brain activity, and blood tests to measure changes in circadian rhythm (the natural body clock). Professor Flohr and colleagues will also examine the lived experience of sleep disturbances related to eczema, as well as its cognitive and psychosocial impact.

Professor Flohr said: “We think the mental health issues seen in children and young people with eczema could in part be explained by chronic inflammation in the skin and blood, leading to sleep disturbance and inflammation in the brain. Thanks to funding from the Foundation, we will be able to address this theory, with the long-term aim of developing strategies to help manage sleep disturbance better. Potentially, this could prevent the knock-on psychological effects we see in children and young people with eczema.”