Mental Health, Sleep Disturbances Tied to Increased Risk for Headache in Children With AD

The association between atopic dermatitis and asthma, sleep and mental health issues with headache in a pediatric population is investigated.

Children and adolescents with atopic dermatitis (AD) who have sleep disturbances, attention deficit hyperactivity disorder (ADHD), asthma, anxiety, or depression may be at a higher risk for headaches, according to study findings published in Pediatric Dermatology.

The study was an analysis of data from the longitudinal birth cohort, The Fragile Families and Child Wellbeing Study. A total of 4898 urban children in the study who were born from 1998 to 2000 were included in the analysis.

In this cohort, investigators performed baseline interviews at birth as well as follow-up interviews with mothers, fathers, and primary caregivers. Interviews were conducted when the child reached the ages of 1, 3, 5, 9, and 15 years. The researchers who analyzed these interview data examined rates and associations between AD and comorbidities with headaches in this pediatric population.

The 5-year, 9-year, and 15-year prevalence rates for AD were 16.4% (95% CI, 15.1%-17.7%), 17.5% (95% CI, 16.3%-18.7%), and 16.0% (95% CI, 14.8%-17.2%), respectively.  

Multivariable logistic regression models revealed an association between AD and headaches at ages 5 years (adjusted odds ratio [aOR], 2.14; 95% CI, 1.27-3.59; P =.0076), 9 years (aOR, 1.69; 95% CI, 1.27-2.27; P =.0009), and 15 years (aOR, 1.71; 95% CI, 1.37-2.14; P =.0002).

In addition, the presence of AD at 9 years of age was associated with higher odds for headaches at 15 years of age (aOR, 1.36; 95% CI, 1.05-1.76; P =.0270).

Children with AD had higher odds for subsequent headaches at 15 years of age

in children at the 2 study waves (aOR, 1.60; 95% CI, 1.12-2.29) and all 3 study waves (aOR, 1.79; 95% CI, 1.16- 2.75).

The investigators found significant 2-way interactions in multivariable repeated measures logistic regression models for AD and sleep disturbances (aOR, 4.59; 95% CI, 3.15-6.69; P =.0002), ADHD (aOR, 2.85; 95% CI, 1.87-4.35; P =.0002), asthma (aOR, 2.87; 95% CI, 2.18-3.76; P =.0002), anxiety (aOR, 2.47; 95% CI, 1.76-3.48; P =.0002), and depression (aOR, 2.86; 95% CI, 1.89-4.34; P =.0002). These comorbidities were considered significant predictors of headaches in this population.

A limitation of this study was the reliance on caregiver-reported diagnosis of AD as well as other comorbidities rather than a clinician report.Also, the investigators did not identify the severity or classification of AD or headaches in this study.

The researchers concluded that future studies may be needed to “determine the underlying mechanisms of association” between AD and headaches throughout childhood “and the optimal approaches to prevent and treat headaches in AD.”


Manjunath J, Silverberg JI. Association between atopic dermatitis and headaches throughout childhood and adolescence-A longitudinal birth cohort study. Published online April 30, 2021. Pediatr Dermatol. doi:10.1111/pde.14607