Spindler M, Przybyłowicz K, Hawro M, Weller K, Reidel U, Metz M, Maurer M, Hawro T. Sleep disturbance in adult dermatologic patients: A cross-sectional study on prevalence, burden, and associated factors.
J Am Acad Dermatol 2021;
85:910-922. [PMID:
33864837 DOI:
10.1016/j.jaad.2021.04.015]
[Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND
Sleep disturbance remains insufficiently characterized in many dermatoses.
OBJECTIVE
To investigate the prevalence, burden, and factors associated with sleep disturbance in dermatologic patients.
METHODS
We recruited 800 patients and recorded pruritus characteristics and sociodemographic and clinical parameters. Validated questionnaires were used to assess sleep disturbance, psychological distress, health-related quality of life, and work productivity.
RESULTS
Two thirds of patients met criteria of poor sleep, which was associated with psychological distress, diminished health-related quality of life, and lost work productivity. Patients with average and maximum pruritus on the visual analog scale exceeding 5 and 6.5 points, respectively, were at high risk of suffering pruritus-related sleep disturbance. Overall pruritus intensity and its nocturnal exacerbation contributed independently to sleep disturbance. Psychological distress was of even higher impact on sleep than pruritus and almost a third of the relationship between pruritus intensity and sleep was mediated by psychological distress.
CONCLUSION
Sleep disturbance is prevalent in dermatologic patients and constitutes a considerable burden.
CLINICAL IMPLICATION
Dermatologic patients with intense pruritus and psychological distress should be examined for sleep disorders. Adequate antipruritic therapy and complementary psychotherapy in affected patients may help them regain restorative sleep.
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