Infants and toddlers with atopic dermatitis are at elevated risk for poor sleep, parental stress, and social-emotional challenges, with poor sleep associated with a more than 13-fold increased risk of socio-emotional delay.
Key Findings
Results
Children with atopic dermatitis showed significantly poorer sleep quality than healthy controls.
Study included 109 children aged 3 months to 2 years with AD and 65 age- and sex-matched healthy controls
Sleep quality difference was statistically significant (p = 0.006)
Children with AD also had increased night awakenings (p = 0.013) and shorter sleep durations (p = 0.010)
Sleep was assessed using the Expanded Brief Infant Sleep Questionnaire (BISQ), a validated parent-report questionnaire
Results
Mothers of children with atopic dermatitis reported significantly higher stress levels than mothers of healthy controls.
Parental stress was measured using the Parenting Stress Index-Short Form (PSI-SF)
The difference in maternal stress levels was highly significant (p < 0.001)
This was a case-control study design with 109 AD cases and 65 controls
Results
Social-emotional developmental delays were more common among children with atopic dermatitis than healthy controls.
Social-emotional development was assessed using the Ages & Stages Questionnaire-Social Emotional (ASQ:SE)
The difference in social-emotional developmental delays between AD children and controls was statistically significant (p = 0.037)
Social-emotional delays were especially prevalent in children with AD who also had poor sleep (p = 0.002)
Results
A diagnosis of atopic dermatitis and lower paternal education were independently associated with poor sleep in multivariate logistic regression analysis.
AD diagnosis was independently associated with poor sleep (OR = 2.12, 95% CI: 1.05–4.29, p = 0.035)
Lower paternal education was also independently associated with poor sleep (OR = 4.60, 95% CI: 1.01–20.77, p = 0.047)
These associations were identified via multivariate logistic regression analysis
Results
Among children with atopic dermatitis, poor sleep was associated with a more than 13-fold increased risk of social-emotional delay.
The odds ratio for social-emotional delay associated with poor sleep among AD children was OR = 13.23 (95% CI: 1.69–103.45, p = 0.014)
This analysis was conducted within the AD group only (n = 109)
The wide confidence interval (1.69–103.45) reflects the relatively small sample size for this subgroup analysis
What This Means
This research suggests that babies and toddlers with atopic dermatitis (eczema) face significant challenges beyond their skin symptoms. Compared to healthy children of the same age and sex, children with eczema slept more poorly, woke up more often at night, and slept for shorter periods overall. Their mothers also reported much higher levels of parenting stress. Perhaps most notably, children with eczema were more likely to show delays in social and emotional development — skills like interacting with others, regulating emotions, and communicating needs.
The study found that the combination of eczema and poor sleep was particularly concerning for development. Among children with eczema, those who slept poorly were more than 13 times more likely to have social-emotional developmental delays compared to those with better sleep. The researchers also found that having an eczema diagnosis and having a father with lower educational attainment were both independently linked to poorer sleep quality in young children.
This research suggests that eczema in early childhood should be viewed as more than a skin condition — it appears to affect the whole family and may interfere with key developmental milestones. The findings point to the importance of early, coordinated care that addresses not only the skin disease itself but also sleep problems, parental stress, and children's developmental needs. Identifying and supporting families affected by infant and toddler eczema early may help prevent broader impacts on child development.
Yılmaz D, Çelik P, Kara Uzun A, Dibek Mısırlıoğlu E. (2026). Evaluation of sleep quality, social-emotional development, and parental stress levels of children with atopic dermatitis.. European journal of pediatrics. https://doi.org/10.1007/s00431-026-06811-y