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Sleep disturbance in adult dermatologic patients: A cross-sectional study on prevalence, burden, and associated
Max Spindler1, Katarzyna Przybyłowicz1, Marlena Hawro1
1Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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.
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