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Sleep disturbance in psoriasis: a case‐controlled study
Author(s) -
Jensen P.,
Zachariae C.,
Skov L.,
Zachariae R.
Publication year - 2018
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.16702
Subject(s) - psoriasis , pittsburgh sleep quality index , medicine , sleep disorder , insomnia , psoriasis area and severity index , beck depression inventory , dermatology life quality index , depression (economics) , population , quality of life (healthcare) , severity of illness , physical therapy , psychiatry , sleep quality , dermatology , anxiety , nursing , macroeconomics , environmental health , economics
Summary Background Sleep is essential for daytime functioning and health. Given the physical symptoms of psoriasis, a higher prevalence of sleep disorders can be expected. So far, the studies examining sleep disturbance in psoriasis have been of less‐than‐optimal methodological quality and with mixed results. Objectives To examine the prevalence of sleep disturbance in patients with plaque psoriasis compared with a control group, to evaluate associations with health‐related quality of life ( HRQ oL) and examine possible disease‐related predictors of disturbed sleep. Methods We used a cross‐sectional, case‐controlled design. Participants included 179 consecutively recruited patients with plaque psoriasis and 105 controls. Measures included psoriasis severity (Psoriasis Area and Severity Index); HRQ oL (Dermatology Life Quality Index); insomnia severity [Insomnia Severity Index ( ISI )]; sleep quality [Pittsburgh Sleep Quality Index ( PSQI )]; stress (Perceived Stress Scale); itch (Itch Severity Scale); and depressive symptoms (Beck Depression Inventory). Analyses included group comparisons and regression analyses to identify predictors of sleep disturbance. Results A total of 25% of patients with psoriasis reported clinical insomnia ( ISI > 15), compared with 10·5% of controls. In all, 53·6% of patients with psoriasis were poor sleepers ( PSQI > 5), compared with 21·9% of controls. Itch was statistically significantly associated with all sleep‐related outcomes. Conclusions A higher proportion of patients with psoriasis experience poor sleep than controls from the general population. Itch was the main predictor of impaired sleep. Improved control of psoriasis with decreased itch may improve sleep disturbance in psoriasis.