A L Henry1,2,3, S D Kyle4, A Chisholm5, C E M Griffiths1,3,6, C Bundy1,2,3. 1. Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, U.K. 2. Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K. 3. Manchester Academic Health Science Centre, University of Manchester, Manchester, U.K. 4. Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, U.K. 5. Department of Psychological Sciences, University of Liverpool, Liverpool, U.K. 6. Salford Royal NHS Foundation Trust, Manchester, U.K.
Abstract
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; η2 = 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.
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; η2 = 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.
Authors: Mary Patricia Smith; Karen Ly; Quinn Thibodeaux; Thulasi Weerasinghe; Kristen Beck; Lindsey Shankle; April W Armstrong; Marc Boas; Alisha Bridges; Frank Doris; Joel M Gelfand; Brian Lafoy; Ana-Maria Orbai; Junko Takeshita; Sarah Truman; Marilyn T Wan; Jashin J Wu; Michael P Siegel; Stacie J Bell; Tina Bhutani; Wilson Liao Journal: Dermatol Ther (Heidelb) Date: 2019-06-08
Authors: C Elise Kleyn; Peter S Talbot; Nehal N Mehta; Francesca Sampogna; Chris Bundy; Darren M Ashcroft; Alexa B Kimball; Peter C M van de Kerkhof; Christopher E M Griffiths; Fernando Valenzuela; Joelle M van der Walt; Tsion Aberra; Lluís Puig Journal: Acta Derm Venereol Date: 2020-01-07 Impact factor: 3.875