Influence of Itch and Pain on Sleep Quality in Atopic Dermatitis and Psoriasis

Acta Derm Venereol. 2019 Feb 1;99(2):175-180. doi: 10.2340/00015555-3065.


Subjective symptoms accompanying atopic dermatitis and psoriasis can negatively influence patients' well-being. This study assessed the impact of itch and pain on sleep quality among 100 patients with atopic dermatitis and 100 patients with psoriasis, compared with 50 controls. The Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate a spectrum of sleep disturbances. Co-existence of insomnia was indicated in the majority of patients; atopic dermatitis; 82%, psoriasis; 62%. PSQI total scores for patients with atopic dermatitis (8.3 ± 4.2 points) and those with psoriasis (8.1 ± 4.8 points) qualified them, in 80% of cases, as poor sleepers and were significantly higher compared with controls (3.1 ± 1.9 points). However, subjects with atopic dermatitis experienced more problems with insomnia and sleep quality than did those with psoriasis. Atopic dermatitis and psoriasis-related itch, but not pain, has a substantial association with insomnia and sleep quality in these patients, and is a crucial subjective symptom in these chronic, inflammatory skin diseases.

Keywords: itch; pain; psoriasis; quality of life; sleep; visual analogue scale; atopic dermatitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Dermatitis, Atopic / complications*
  • Dermatitis, Atopic / diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis
  • Pain / etiology*
  • Pruritus / diagnosis
  • Pruritus / etiology*
  • Psoriasis / complications*
  • Psoriasis / diagnosis
  • Risk Factors
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / etiology*
  • Sleep Initiation and Maintenance Disorders / physiopathology
  • Sleep*
  • Young Adult