Evaluation of Sleep Disturbance in Alopecia Areata through Questionnaire: Pittsburgh Sleep Quality Index as a Reasonable Tool

Abstract

Background Alopecia areata (AA) is common non-scarring hair loss disease. Sleep distrubance has been regarded as a triggering or aggravating factor for AA. However, objective evaluation of sleep disturbance and its clinical effect on AA has not been clearly demonstrated. Objective This study investigated objective sleep evaluation tool for AA patients and their clinical correlation. Methods Patients presenting with new-onset AA or recurrences of pre-existing AA were included, and those who reported sleep disturbance in the preliminary survey were designated as the sleep disturbance group (SD group). Sleep quality was investigated for them using three self-administered questionnaires: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleep Scale (ESS). Demographic information and clinical features of AA were analyzed according to sleep quality. Results A total of 400 participants were enrolled, and 53 were categorized into the SD group. The incidence of stressful events was significantly higher in the SD group (54.7%) than in the non-SD group (25.1%) ( p <0.001). Based on the PSQI, 77.3% of participants were objective poor sleepers (score of 5 or more), and they showed a significantly higher incidence of stressful events compared to good sleepers ( p =0.019). The proportion of poor sleepers was significantly lower in patients with mild AA (S1) than in those with moderate to severe AA (S2~S5) ( p =0.045). Conclusion This study demonstrated a positive correlation among stress, SD, and AA. The degree of SD was objectively represented by the PSQI score, showing different scores according to AA severity.

Comparing quality of life, anxiety, depression, sleep disturbance, and associated factors in vitiligo and alopecia areata patients

“…The higher prevalence of sleep disorders in our study might be attributed to the difference in diagnostic methods between the two studies. Regarding sleep disturbance in AA patients, more than three‐quarters (77.3%) of the patients had poor quality of sleep based on the PSQI score of 5 or higher, which was in line with the current study 49 …”

“…Regarding sleep disturbance in AA patients, more than threequarters (77.3%) of the patients had poor quality of sleep based on the PSQI score of 5 or higher, which was in line with the current study. 49 We did not find any correlation between sleep disturbance and demographic or disease-related factors in patients with vitiligo and AA, which is consistent with Öztekin et al 50 study findings.…”