Sleep Disorders and Psoriasis: An Update

Abstract

Psoriasis alters patients’ quality of life. Among the disorders associated with psoriasis, sleep disorders are common, although they are not directly assessed by most quality-of-life scores. Thus, their specific evaluation with dedicated scores is necessary, especially because such disorders alter physical and psychological health. The relationship between psoriasis and sleep disorders has not yet been fully elucidated, but numerous studies in the literature show links between the two. Our study aims to update knowledge about sleep disorders in patients with psoriasis through a review of the scientific literature since 1980. This work covers several topics of interest, such as sleep assessment methods, the prevalence of sleep disorders in patients with psoriasis, factors predictive of sleep disorders in patients with psoriasis, the impact of sleep disorders on comorbidities and quality of life, pathogenic mechanisms, obstructive sleep apnoea and restless leg syndromes, and the impact of biotherapy treatments on sleep disorders in patients with psoriasis.

The Impact of Sleep Quality on Mood Status and Quality of Life in Patients with Alopecia Areata: A Comparative Study

“…Similar studies have been performed regarding sleep quality and other skin conditions, such as psoriasis [ 9 , 15 ]. Interestingly, in these cases, a significant correlation was found between the severity and symptoms of the disease (pain, tender points), as well as subjective wellness (visual analogue scale) and sleep quality indicators.…”

“…On the other hand, insomnia and sleep disorders are frequent among the general population [ 5 ] and have been associated with a variety of cardiovascular [ 6 ], neurologic [ 7 ] or psychiatric [ 8 ] complications. Moreover, a worse sleep quality has been described in a variety of chronic skin diseases such as psoriasis [ 9 ], atopic dermatitis [ 10 ] or chronic spontaneous urticaria [ 11 ]. In this regard, recent studies [ 12 ] identify a complex interplay among various physiological, psychosocial and behavioral factors mediating the relationship between sleep loss and chronic inflammatory skin diseases.…”

Sleep disturbance and psoriasis

“…Although the high prevalence of sleep disturbance in patients with psoriasis has been previously evidenced, and two systematic reviews and a recent update were performed, 2–4 dermatologists are poorly aware of this comorbidity. In a large study, we also showed that sleep disorders were very frequent in patients with inflammatory skin diseases, including psoriasis 5 .…”

“…The role of non-inflammatory conditions like obstructive sleep apnoea and restless leg syndrome has been previously suggested. 4 The presence of inflammatory mediators, like TNFa or substance P, in the blood and consequently the brain of psoriasis patients could also directly favour sleep disorders in these patients. 4 Hence, several factors could be involved (Fig.…”

“…4 The presence of inflammatory mediators, like TNFa or substance P, in the blood and consequently the brain of psoriasis patients could also directly favour sleep disorders in these patients. 4 Hence, several factors could be involved (Fig. 1).…”