Journal of the American Academy of Dermatology
Volume 63, Issue 1 , Pages 114-123, July 2010

Factors affecting sleep quality in patients with psoriasis

  • Smitha Gowda, MD

      Affiliations

    • University of Maryland School of Medicine, Baltimore, Maryland
    • ,
  • Orin M. Goldblum, MD

      Affiliations

    • Abbott Laboratories, Abbott Park, Illinois
    • ,
  • W. Vaughn McCall, MD, MS

      Affiliations

    • Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
    • ,
  • Steven R. Feldman, MD, PhD

      Affiliations

    • Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
    • Corresponding Author InformationCorrespondence to: Steven R. Feldman, MD, PhD, Department of Dermatology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1071.

published online 30 November 2009.

Poor sleep quality adversely affects quality of life in patients with psoriasis. However, the factors impairing sleep in these patients have not been well described. We reviewed the available literature linking sleep quality and psoriasis to elucidate factors that interfere with sleep. Pruritus, depression, pain, and obstructive sleep apnea may be likely sources of sleep impairment in patients with psoriasis. Fatigue resulting from sleep interference may also be implicated in this relationship. Pruritus, depression, and pain interfere with sleep quality by increasing nocturnal awakenings and sleep fragmentation. Obstructive sleep apnea may occur in a greater percentage of patients with psoriasis than control populations. Factors associated with psoriasis appear to have similarities in their cytokine and neuropeptide profiles. Moreover, these variables are complex and interconnected. Further study and awareness of potential factors impacting sleep in patients with psoriasis may provide new avenues for treatment of recalcitrant disease.

Key words: dermatology, itch, psoriasis, sleep

Abbreviations used: IL, interleukin, OSA, obstructive sleep apnea, SP, substance P, TNF, tumor necrosis factor, WTP, willingness to pay

 

 Funding for manuscript development was provided by Abbott Laboratories. The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, LP.

 Disclosure: Dr Goldblum is an employee of Abbott Laboratories and owns Abbott stock. Dr McCall has served as an investigator for GlaxoSmithKline, Mini Mitter, the National Institutes of Health, Sanofi-Aventis, Sealy, Sepracor, and Somaxon, receiving research grants; has served as a consultant for AstraZeneca, Orexo AB, Sepracor, and Somaxon, receiving honoraria; and has served as a member of the speakers' bureaus for Sanofi-Aventis and Sepracor, receiving honoraria. Dr Feldman has served as an advisory board member, investigator, and speaker for Abbott Laboratories, Astellas, Galderma, Steifel, and Warner Chilcott, receiving grants and honoraria; has served on the advisory board for Photomedex, receiving stock options; has been an investigator and speaker for Amgen, Centocor, and Genentech, receiving grants and honoraria; and has served as an advisory board member and speaker for the National Psoriasis Foundation, receiving honoraria. Ms Gowda has no conflicts to declare.

 Reprints not available from the author.

PII: S0190-9622(09)00886-X

doi:10.1016/j.jaad.2009.07.003

Journal of the American Academy of Dermatology
Volume 63, Issue 1 , Pages 114-123, July 2010