The Assessment of Risk and Predictors of Sleep Disorders in Patients with Psoriasis—A Questionnaire-Based Cross-Sectional Analysis

Abstract

Psoriasis is a chronic, inflammatory skin disease affecting 2–4% of the general population. Accompanying subjective symptoms (pruritus or pain) may cause decreased life quality including sleep disorders (SD). Sixty psoriatic patients fulfilled the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), STOP BANG for the obstructive sleep apnea syndrome (OSAS) assessment, and Restless Legs Syndrome (RLS) Severity Scale. Patients’ laboratory and clinical data were also investigated. All data obtained were compared to 40 participants without dermatoses. Mean PSQI, risk of OSAS, and RLS severity of psoriatics were significantly higher than in controls (p < 0.0001, p < 0.05, p < 0.05 respectively). There was a positive correlation between the time of suffering from psoriasis and the risk of OSAS (R = 0.286, p < 0.05). We did not observe any significant relationship between PSQI, risk of OSAS, or RLS and psoriasis severity assessed with PASI (Psoriasis Area and Severity Index). We identified four possible predictors of RLS: glucose, CRP and total cholesterol concentrations, and PSQI. SD are significantly more frequent in psoriatics than in people without chronic dermatological diseases but surprisingly they are not correlated with psoriasis severity. SD decrease patients’ life quality and may result in serious consequences. Therefore, establishing recommendations concerning screening for SD and their predictors should be considered.

Mutual Relationship Between Sleep Disorders, Quality of Life and Psychosocial Aspects in Patients With Psoriasis

“…Among all SD in such patients, RLS is probably the least studied and uncertain. Nevertheless, in our previous research, we proved that patients with psoriasis had more severe symptoms of RLS (6). Similar outcomes are obtained by Saçmaci et al (7).…”

“…We also found that such patients slept significantly fewer hours and took more sleeping medications. Therefore, we believed that SD should be taken into account in daily clinical practice, and reliable recommendations regarding its early detection should be established ( 6 ).…”

“…Psoriasis is one of the most common dermatological diseases in clinical practice. Nowadays, it is treated not only as a skin-related problem, but more as a disorder characterized by autoimmune and inflammatory processes affecting the body's organs and accompanied by multiple comorbidities ( Figure 1 ) ( 5 , 6 ).…”

Aberrations in Lipid Expression and Metabolism in Psoriasis

“…It is estimated that about 30% of patients will develop psoriatic arthritis [ 3 ]. Other disorders occurring more frequently in psoriatic patients are inflammatory bowel diseases, neoplasms, and neurodegenerative and sleep disorders [ 4 , 5 ]. Nevertheless, the most thoroughly investigated and closest relationship of PSO is probably that with metabolic syndrome (MS) and other cardiometabolic diseases (CMDs) [ 3 , 6 ].…”

Subclinical Cardiac Organ Damage in Patients with Moderate to Severe Psoriasis

“…Having psoriasis has, in varying degree, been associated with an elevated risk of cardiovascular (CV) disease [ 5 ]. This is in part related to the high prevalence of CV risk factors in psoriasis, in particular hypertension and obesity [ 5 , 6 ]. In a British registry of patients with moderate to severe psoriasis receiving biological systemic treatment, 73% of patients were overweight or obese and 31% had hypertension [ 7 ].…”