Commentary: Prevalence and Factors Associated with Sleep Disturbance in Adult Patients with Psoriasis

Sleep disorders have a high prevalence in patients with psoriasis and significantly impact their physical and psychological well-being. The relationship between sleep disorders and psoriasis has been analyzed in numerous studies but remains poorly understood, primarily due to potential confounding factors such as pruritus, anxiety, or depression.

In this article, researchers from Berlin and Lübeck (Germany) dive deeper into understanding the impact of sleep disturbances in patients with psoriasis to identify clinical, demographic, and psychological factors. Using validated questionnaires for evaluating sleep and other measurements of quality of life, they compared psoriasis patients with a group of healthy individuals.

The significant findings of their study revealed that the prevalence of sleep disturbances was higher in psoriasis patients, and sleep was more impaired compared to healthy subjects. No association between sleep disturbance and psoriasis severity was observed, although most patients with sleep disturbances had well-controlled mild psoriasis. Other findings include observations that intense pruritus that occurred at bedtime was associated with impaired sleep (probably due to direct interference with sleep). Sleep disturbances were associated with anxiety, depression, and diminished health-related quality of life, particularly in female psoriasis patients. Increased levels of anxiety and depression were the main predictors of sleep impairment (better than pruritus parameters altogether).

The limitation of the current study includes the inability to define a causal relationship between sleep disturbances and their associated factors. However, it does not detract from the merits of this study that helps us better understand sleep disorders in patients with psoriasis, raising the possibility that complementary psychotherapy aimed at reducing anxiety, depression, and psychological distress may help to improve sleep in our patients.