Emerald Touchless Sensor Quantifies Nighttime Scratching and Sleep Quality in Children With Atopic Dermatitis: PEDISTAD EMERALD Study

In children with atopic dermatitis (AD), itch-related nighttime scratching is associated with significant sleep disturbances. The aim of this study is to report the feasibility of using the Emerald touchless sensor to quantify nighttime scratching and sleep patterns in pediatric patients. PEDISTAD EMERALD (NCT05235724), an open-label, 12-week, exploratory study, included 20 pediatric patients with moderate-to-severe AD aged 6–11 years from the PEDISTAD registry (NCT03687359). The Emerald touchless sensor measures sleep onset and efficiency. Correlation analyses were performed between sleep onset and Peak Pruritus Numeric Rating Scale (PP-NRS), scratching events and time per hour and PP-NRS, and weekly averages of nightly scratching events per hour and sleep efficiency. We show strong statistically significant correlations between sleep onset and PP-NRS (Pearson correlation coefficient: r = 0.50; p = 0.049) and between scratching events per hour and sleep efficiency (r = − 0.66; p = 0.003). Additionally, we observed positive correlations between scratching events (r = 0.46; p = 0.076) and scratching time per hour (r = 0.43; p = 0.096) and PP-NRS that did not reach statistical significance. The Emerald touchless sensor can provide objective measures of itch-related scratching and sleep disturbance in children with AD in a home setting, demonstrating its feasibility for use in pediatric clinical trials. NCT05235724. Children with atopic dermatitis (AD) experience itch and scratching leading to sleep disruption. This study tested a wall-mounted device called the Emerald touchless sensor for measuring sleep patterns. Unlike wearable devices that can irritate sensitive skin, this sensor works without touching the patient. It is placed in the patient’s bedroom and transmits radio waves, which bounce off their body. Scratching correlates with sleep disruption and leads to changes in these waves, which are analyzed using computer learning. In the PEDISTAD EMERALD trial, the sensor was used to collect sleep data over 12 weeks in 20 children aged 6 to 11 years with moderate-to-severe AD, who received treatment for AD as prescribed by their doctors. The sensor measured how long it took children to fall asleep, how well they slept, and how much they scratched overnight. Patients or their caregivers also completed daily questionnaires of itch intensity on a scale from 0 (no itch) to 10 (worst itch imaginable). We found that the sensor successfully captured data on 96% of nights and that falling asleep took longer in children who reported more intense itch. The sensor’s measurements on scratching matched the intensity of patient-reported itch well. Also, more nighttime scratching was strongly linked to poorer quality of sleep. This study showed that the sensor is easy to use and demonstrated feasibility to measure scratching and sleep disturbances in children with AD. The Emerald touchless sensor may help in understanding how AD affects children’s sleep and how well the treatment works, with potential for future clinical applications.