Associations of Healthy Sleep Patterns with Psoriasis Risk: Insights from a Longitudinal Cohort Study

While sleep disturbances are prevalent among individuals with psoriasis, the influence of overall sleep behaviors on psoriasis risk remains unclear. This study aims to investigate the association between overall sleep behaviors and the risk of psoriasis and its subtypes.

This analysis included 405,258 participants. Five sleep behaviors were assessed via questionnaire and used to construct a sleep score (0-5) based on low-risk factors: sleep duration (7-8 h/day), early chronotype, never or rarely insomnia, no snoring, and infrequent daytime sleepiness, with higher scores indicating healthier sleep patterns. Cox proportional hazards models assessed the associations between sleep patterns, individual behaviors, and the risk of psoriasis and its subtypes. Dose-response relationships were further explored using restricted cubic spline models.

During a median follow-up of 13.6 years, 2715 cases of psoriasis were identified, including 523 psoriatic arthritis (PsA) and 2192 non-PsA cases. Healthy sleep scores were associated with a dose-response reduction in the risks of psoriasis and its subtypes. Compared to participants scoring 0-1, those scoring 5 had hazard ratios (95% CL) of 0.69 (0.56-0.87) for incident psoriasis, 0.61 (0.38-0.98) for incident PsA, and 0.69 (0.54-0.88) for incident non-PsA. Participants without frequent daytime sleepiness had a 19% lower risk of psoriasis, while the other four low-risk behaviors were associated with an 8% reduction in risk. Additionally, the inverse association was stronger in individuals under 60 compared to older participants (P-interaction = 0.003).

Maintaining healthy sleep patterns is associated with a significantly lower risk of developing psoriasis, especially in younger individuals.