Cervical Spine Range of Motion and Sleep Disturbances in Patients With Atopic Dermatitis: A Cross-Sectional Study.

BACKGROUND

Sleep disturbances are common and distressing among patients with atopic dermatitis (AD), often resulting in a cycle of worsening skin conditions. Among various factors affecting sleep in AD, cervical spine movement has been suggested to influence sleep quality; however, these studies mostly relied on subjective measures. Owing to the lack of objective and quantitative analyses of cervical spine movement, its association with sleep disturbances remains poorly understood. This exploratory study aimed to investigate the relationship between quantitatively measured cervical spine range of motion (ROM) and sleep disturbances in patients with AD and to further explore connections with inflammatory and allergy-related markers.

METHODS

A cross-sectional study was conducted on 261 patients with AD aged 18-60 years. Sleep disturbances and pruritus were assessed using Numerical Rating Scales (NRS). Cervical spine ROM was quantitatively measured using an automatic measurement system based on flexion-extension X-rays. Hematological parameters, including total serum immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), peripheral eosinophil count, and neutrophil-to-lymphocyte ratio (NLR), were analyzed. Group comparisons based on the median cervical ROM and ordinal logistic regression analysis were performed to explore the relationships between these variables.

RESULTS

Patients with higher cervical spine ROM (≥86°) had significantly lower Sleep Disturbance NRS scores and lower levels of inflammatory and allergy-related markers (IgE, TARC, LDH, and NLR) than patients with lower ROM (<86°) (p < 0.05). Ordinal logistic regression analysis revealed that pruritus severity (odds ratio (OR): 3.97, p < 0.001) and age (OR: 1.60, p < 0.001) were positively associated with sleep disturbances, whereas cervical spine ROM was negatively associated with sleep disturbances (OR: 0.72, p = 0.021). TARC levels were positively associated with sleep disturbances (OR: 1.98, p < 0.001).

CONCLUSIONS

This study revealed a significant association between cervical spine ROM and sleep disturbances in patients with AD. Higher cervical spine mobility was associated with better sleep quality and lower inflammatory marker levels. These findings suggest the potential of cervical spine interventions in managing sleep disturbances and inflammation in patients with AD. Nonetheless, further research is required to explore the causal relationships and efficacy of targeted interventions.