Hosono Shusaku, Fujita Koji, Nimura Akimoto, Ibara Takuya, Akita Keiichi
Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, JPN.
HealthTech Design Section, Center for Medical Innovation, Institute of Science Tokyo, Tokyo, JPN.
Cureus. 2024 Dec 10;16(12):e75449. doi: 10.7759/cureus.75449. eCollection 2024 Dec.
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.
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.
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).
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.
睡眠障碍在特应性皮炎（AD）患者中很常见且令人苦恼，常导致皮肤状况恶化的恶性循环。在影响AD患者睡眠的各种因素中，颈椎活动被认为会影响睡眠质量；然而，这些研究大多依赖主观测量方法。由于缺乏对颈椎活动的客观定量分析，其与睡眠障碍的关联仍知之甚少。这项探索性研究旨在调查AD患者中定量测量的颈椎活动范围（ROM）与睡眠障碍之间的关系，并进一步探索与炎症和过敏相关标志物的联系。
对261名年龄在18至60岁之间的AD患者进行了横断面研究。使用数字评分量表（NRS）评估睡眠障碍和瘙痒程度。使用基于屈伸位X线片的自动测量系统对颈椎ROM进行定量测量。分析血液学参数，包括总血清免疫球蛋白E（IgE）、胸腺和活化调节趋化因子（TARC）、乳酸脱氢酶（LDH）、外周血嗜酸性粒细胞计数和中性粒细胞与淋巴细胞比值（NLR）。基于颈椎ROM中位数进行组间比较并进行有序逻辑回归分析，以探讨这些变量之间关系。
颈椎ROM较高（≥86°）的患者与ROM较低（<86°）的患者相比，睡眠障碍NRS评分显著更低，炎症和过敏相关标志物（IgE、TARC、LDH和NLR）水平也更低（p < 0.05）。有序逻辑回归分析显示，瘙痒严重程度（比值比（OR）：3.97，p < 0.001）和年龄（OR：1.60，p < 0.001）与睡眠障碍呈正相关，而颈椎ROM与睡眠障碍呈负相关（OR：0.72，p = 0.021）。TARC水平与睡眠障碍呈正相关（OR：1.98，p < 0.001）。
本研究揭示了AD患者颈椎ROM与睡眠障碍之间存在显著关联。颈椎活动度越高，睡眠质量越好，炎症标志物水平越低。这些发现表明颈椎干预在管理AD患者睡眠障碍和炎症方面具有潜力。尽管如此，仍需要进一步研究以探索因果关系和针对性干预措施的疗效。
