Insomnia and other sleep complaints in inflammatory versus noninflammatory skin disorders: An observational case-control study

Int J Dermatol. 2019 Aug;58(8):976-981. doi: 10.1111/ijd.14488. Epub 2019 Jun 5.

Abstract

Background: Sleep problems are common in patients with dermatologic disorders. However, it is unknown whether inflammatory skin disorders are associated with more sleep problems than noninflammatory skin disorders.

Purpose: To determine whether sleep problems occur more frequently in people with inflammatory skin disorders compared to noninflammatory skin disorders.

Study design: Observational case-control study.

Methods: Patients with inflammatory skin disorders (psoriasis [n = 17] and chronic eczema [n = 30]) and noninflammatory skin disorders (nonmelanoma skin cancers [NMSC] [n = 31]) were enrolled. Data collection occurred during a single visit. Statistical analysis of questionnaire results between groups utilized inverse propensity score weighted (IPSW) ANOVA and logistic regression models.

Results: Groups differed in mean (SD) age (P < 0.001) and itch severity (P < 0.001). Based on IPSW ANOVA models, the inflammatory group had significantly higher fatigue scores (mean [95% CI]; 32.0 [28.4-35.5]) than the noninflammatory group (25.5 [21.6-29.3]; P = 0.017). The inflammatory group odds of insomnia were significantly greater based on two definitions of insomnia, ISI ≥ 15 and PSSQ-I, with odds ratios (95% CI) of 14.4 (2.16-525) and 4.82 (1.45-20.7), respectively. These results were consistent in comparisons between the three groups, with no difference between psoriasis and chronic eczema, but with chronic eczema, significantly more were affected than NMSC.

Conclusions: Patients with inflammatory skin disorders report significantly more fatigue and have higher odds of insomnia compared to patients with noninflammatory skin cancers.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Chronic Disease
  • Eczema / complications*
  • Fatigue / diagnosis
  • Fatigue / epidemiology*
  • Fatigue / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Psoriasis / complications*
  • Severity of Illness Index
  • Skin Neoplasms / complications*
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / etiology
  • Surveys and Questionnaires / statistics & numerical data
  • Young Adult