The influence of sleep quality on the development of periocular hyperchromia: a case-control study

Periorbital hyperchromia (POH), popularly known as "dark circles," is a very frequent complaint in dermatological appointments. It affects all phototypes, genders, and ages, and it is associated with a tired and aged aspect to the face, which may lead to esthetic concerns and impairments in the quality of life. Its etiology is multifactorial, and it is believed that sleep disorders may be considered as precipitating or aggravating factors.

Our objective is to compare sleep quality (using the Pittsburgh Sleep Quality Index-PSQI) of patients with POH to patients without this complaint.

A single-center, case-control study. Patients from both genders were included. Cases were patients with POH, and controls had no POH. Demographic data, Dermatology Life Quality Index (DLQI), and PSQI were collected. A power of 80% and statistical significance when a P-value was lower than .05 were stipulated.

Out of 303 patients, 149 cases and 154 controls, with a mean age of 35.83 ± 11.38 for cases and 37.52 ± 14.89 for controls, there was no significant difference between groups. The DLQI revealed a mean of 4.86 ± 4.89 for cases and 2.25 ± 3.73 for controls (P < .0001), which translates into a modest effect in life quality. The PSQI mean was 5.93 ± 2.52 for cases and 6.14 ± 3.58 for controls (P = .633), which characterizes the poor quality of sleep.

Dark circles impact negatively on the quality of life of affected patients, especially in women. Contrary to what has been believed, sleep alone does not seem to influence the appearance of POH. NCT03393624.