Sleep disorders in dermatology – a comprehensive review

Abstract

Summary Sleep is a normal physiological process that accounts for approximately one third of a person's life. Disruption of the normal sleep cycle, which maintains physiological homeostasis, can lead to pathology. It is not known whether sleep disturbance causes skin disease or skin disease causes sleep impairment, but a bidirectional influence is suspected. We have compiled the data from published articles on “sleep disorders in dermatology” in PubMed Central from July 2010 to July 2022 (with the option “full text available”) and provide an overview of sleep disorders associated with dermatological conditions and certain drugs used in dermatology as well as sleep disturbances for which some drugs used can cause itch or dermatological issues. Atopic dermatitis, eczema and psoriasis have been shown to be exacerbated by sleep problems and vice versa. Sleep deprivation, night‐time pruritus and disrupted sleep cycles are often used to assess treatment response and quality of life in these conditions. Some medications used primarily for dermatological conditions have also been associated with alterations in the sleep‐wake cycle. Addressing patients sleep disorders should be an integral part of the management of dermatological conditions. More studies are needed to further investigate the influence of sleep and skin disorders.

Burden of impaired sleep and its improvement through topical treatment in psoriasis and atopic dermatitis

“…An occasional occurrence has been reported for 20% of people 25 . Similar to our findings, the overall reported prevalence of sleep disturbances in patients with chronic inflammatory skin diseases is strikingly higher with 33%–90% in AD and 6%–35% in PSO 1 . Silverberg et al.…”

“…25 Similar to our findings, the overall reported prevalence of sleep disturbances in patients with chronic inflammatory skin diseases is strikingly higher with 33%-90% in AD and 6%-35% in PSO. 1 Silverberg et al saw an increased risk for poorer overall health status in eczema patients with sleep disturbances, which underlines the relevance of screening to enable early intervention. 4 In accordance with our findings, Kaaz et al also found more pronounced sleep disturbances in patients with AD than with psoriasis; however, objectifiable data are missing.…”

“…31 This makes an effect on chronic inflammatory skin diseases likely and the analysis of biomarkers for skin inflammation noteworthy. 1 An AHI greater than or equal to 15 is suggestive of OSAS. 32 The mean AHI in AD and PSO patients was 15.1 and 20.2.…”

“…Patients with chronic inflammatory skin diseases suffer from impaired sleep and fatigue. [1][2][3][4][5] Sleep quality is largely dependent on two sleep phases in particular, which may be affected by these diseases: Rapid Eye Movement (REM) sleep, also known as the dream sleep, which is essential for processing of sensory impressions and recovery and deep sleep (N3), which is fundamental for memory consolidation and cognitive performance. 6,7 Different parameters, such as increased body weight raising the risk for obstructive sleep apnea (OSAS), can negatively affect sleep quality.…”

Sexual dysfunctions in psoriatic patients

“…Furthermore, these illnesses increase the probability of cardiovascular events ( 1 ). Additionally, previous research shows that the patients suffer from insomnia and have poor sleep quality ( 3 ). The comorbidities mentioned earlier enhance directly the risk of sexual dysfunction in both male and female patients ( 4 ).…”