A cross‐sectional survey of the nature and correlates of sleep disturbance in people with psoriasis. (12th July 2017)

• Record Type: Journal Article
• Authors: Henry, A.L.; Kyle, S.D.; Chisholm, A.; Griffiths, C.E.M.; Bundy, C.
• Is Part Of: British journal of dermatology. Volume 177:Number 4(2017)
• Page Start: 1052
• Page End: 1059
• Publication Date: 2017-07-12
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.15469
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Research suggests that sleep disturbance is common in psoriasis. While several sleep investigations have been conducted in psoriasis populations, many have methodological shortcomings, and no study has examined multiple dimensions of sleep–wake functioning. Moreover, research has yet to be performed comprehensively examining the range of physical and psychological factors that may affect sleep in people with psoriasis. Objectives: To characterize sleep disturbance using validated measures and to identify physical and psychological predictors of sleep quality in people with psoriasis. Methods: An online survey was conducted (186 respondents; mean age 39·2 years) comprising validated measures assessing sleep [Pittsburgh Sleep; Quality Index (PSQI), Berlin Questionnaire, Pre‐Sleep Arousal Scale]; chronotype (Morningness–Eveningness Questionnaire); mood (Hospital Anxiety and Depression Scale); itch (5‐D Itch Scale); and psoriasis severity (Simplified Psoriasis Index). Group comparisons and regression analyses were used to examine predictors of poor sleep. Results: The mean PSQI score was 9·2 ± 4·3, with 76·3% scoring above the threshold for poor sleep (≥ 6 on the PSQI) and 32·5% scoring 'positive' for probable obstructive sleep apnoea (OSA). Poor sleep and high likelihood of OSA were associated with more severe psoriasis ( P < 0·05; η = 0·07; η 2 = 0·005). Cognitive arousal (β = 0·26, P = 0·001), itch (β = 0·26, P < 0·001) and depression (β = 0·24, P = 0·001) were the most robust predictors of poor sleep quality, which, together with somatic arousal (β = 0·17, P = 0·022), accounted for 43% of variance in PSQI scores. Conclusions: Poor sleep is common in psoriasis and associated with psychological and physical factors. Rates of probable OSA are also high. Given the importance of restorative sleep for health, sleep complaints should receive greater clinical attention in the management of psoriasis. Abstract : What's already known about this topic? Estimated rates of sleep disturbance in psoriasis vary widely. Current research does not provide a comprehensive assessment of sleep, including possible physical and psychological factors associated with poor sleep. What does this study add? Poor sleep is common in psoriasis, affecting over 75% of our sample. Poor sleep quality is associated with presleep cognitive arousal, itch, low mood and presleep somatic arousal. Possible treatment targets for improved sleep are identified. Linked Comment:Egeberg. Br J Dermatol 2017; 177:899–900 . Plain language summary available online