Sleep disturbance is highly prevalent among patients with psoriasis and is associated with pruritus, anxiety, and depression, according to a study published online Jan. 12 in the Journal of the European Academy of Dermatology and Venereology .

Elvan Sahin, from the Universitätsmedizin Berlin, and colleagues examined sleep characteristics and factors associated with sleep disturbance in a cross-sectional study involving 334 psoriasis patients and 126 controls (response rates, 86 and 82 percent, respectively).

The researchers found that 59 and 34 percent of patients and controls had sleep disturbance, respectively. Compared with controls, patients slept one hour less (median, six versus seven hours). Compared with patients with strong and very strong pruritus, those without pruritus had less impaired sleep. The strongest predictors of sleep impairment were anxiety and depression levels, followed by pruritus exacerbation at night, age, female sex, pruritus exacerbation in the morning, average pruritus intensity, diagnosed depression, and gastroesophageal reflux disease; together, these accounted for 32 to 37 percent of the global sleep quality variance. Significant mediators explaining the association between pruritus intensity and sleep impairment were anxiety and depression, accounting for 42 and 37 percent, respectively.

"We reveal an alarmingly high prevalence of sleep disturbance in a population of patients with prevailingly well controlled psoriasis. Patients with psoriasis should be assessed for sleep impairment, pruritus, anxiety, and depression," the authors write. "Providing complementary psychotherapy aimed at reducing anxiety, depression and psychological distress may help to improve sleep in patients with psoriasis."

The study was partially funded by Leo Pharma.

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