Sleep disturbance in adult dermatologic patients: A cross-sectional study on prevalence, burden, and associated factors.
activity
anxiety
depression
pruritus
psychological distress
quality of life
sleep quality
work productivity
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
30
11
2020
revised:
26
03
2021
accepted:
02
04
2021
pubmed:
18
4
2021
medline:
1
3
2022
entrez:
17
4
2021
Statut:
ppublish
Résumé
Sleep disturbance remains insufficiently characterized in many dermatoses. To investigate the prevalence, burden, and factors associated with sleep disturbance in dermatologic patients. 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. 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. Sleep disturbance is prevalent in dermatologic patients and constitutes a considerable burden. 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.
Sections du résumé
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.
Identifiants
pubmed: 33864837
pii: S0190-9622(21)00781-7
doi: 10.1016/j.jaad.2021.04.015
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
910-922Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest Dr Weller has received honoraria as a speaker and/or consultant for CSL Behring, Dr R. Pfleger, Novartis, Moxie, Shire/Takeda, UCB, Uriach, and Viropharma. Dr Metz has received honoraria as a speaker and/or consultant for Aralez Pharmaceuticals, argenx, Bayer, Beiersdorf, Celgene, Menlo, Moxie, Novartis, Roche, Sanofi, Sienna Biopharmaceuticals, and Uriach. Dr Maurer is or recently was a speaker and/or advisor for and/or has received research funding from Allakos, Amgen, Aralez, ArgenX, AstraZeneca, Celldex, Centogene, CSL Behring, FAES, Genentech, GI Innovation, Innate Pharma, Kyowa Kirin, Leo Pharma, Lilly, Menarini, Moxie, Novartis, Roche, Sanofi/Regeneron, Third HarmonicBio, UCB, and Uriach. Dr Hawro has received honoraria as a speaker and/or consultant for Moxie, Galderma, and Roche. Drs Spindler, Przybyłowicz, Hawro, and Reidel have no conflicts of interest to declare.