Despite a widely reported prevalence of sleep disturbances among psoriasis patients, discrepant results exist regarding the quantitative effect of psoriasis on sleep.
Now, a new study suggests that the jury is in. Psoriasis is associated with poor sleep quality and higher risk for sleep disturbances, especially among patients with psoriatic arthritis, severe psoriasis, shorter duration of psoriasis, and younger age.
There are many potential ways that psoriasis may affect sleep, the study authors note. Pruritus in psoriasis usually worsens nocturnally and skin lesions in psoriasis may reduce sweat rate and the ability to dissipate heat, disrupting thermoregulation and deteriorating the induction of sleep. In addition, depression travels with psoriasis and is frequently associated with poor sleep quality.
To get a better handle on how psoriasis affects sleep quality, researchers conducted a literature search for cross-sectional, case-control or cohort studies of psoriasis patients and healthy controls that reported data regarding Pittsburgh Sleep Quality Index (PSQI) and the prevalence of sleep disturbance (SD) based on the PSQI, published from inception up to January 2023. Secondary outcomes included scores for the Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), and Epworth Sleepiness Scale (ESS), and risk for restless legs syndrome (RLS).
The research included 15 studies comprising 1274 psoriasis patients and 775 controls. patients with psoriasis had a higher PSQI and a higher risk for SD compared with controls. Subgroup analyses revealed a greater difference in PSQI score and/or risk for SD between patients with psoriasis and controls in subgroups of psoriatic arthritis, moderate-to-severe psoriasis, shorter psoriasis duration, and younger age. Moreover, Patients with psoriasis were also more likely to experience insomnia, RLS, and depression. There were no significant difference in ESS scores in psoriasis patients compared with controls, the study showed.
The study appears in the January 2024 issue of the Journal of Psychosomatic Research.