The functional burden of chronic urticaria: Sleep quality, activity impairment and work productivity

Chronic urticaria (CU) is associated with a substantial disease burden extending beyond cutaneous manifestations. It may impair psychological well-being, sleep quality, daily functioning, and work productivity, although these domains have rarely been evaluated simultaneously.

To investigate sleep quality, psychological status, activity impairment, and work productivity in patients with chronic urticaria and identify factors independently associated with the disease.

This cross-sectional case-control study included 108 patients with chronic urticaria and 95 healthy controls. Sleep quality, psychological status, and work productivity were assessed using the Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale-21 (DASS-21), and Work Productivity and Activity Impairment Questionnaire (WPAI). Multivariable logistic regression analysis was performed to identify factors independently associated with chronic urticaria.

Patients with chronic urticaria had significantly poorer sleep quality, higher depression and anxiety scores, and greater activity impairment than controls (all p < 0.05). In multivariable analysis, higher PSQI, depression, stress, and activity impairment scores were independently associated with chronic urticaria (all p < 0.05). Among employed participants, absenteeism, presenteeism, and overall work productivity impairment were significantly greater in patients (all p < 0.001).

Chronic urticaria is associated with impaired sleep quality, psychological distress, activity impairment, and reduced work productivity. These findings highlight the multidimensional burden of the disease and support a holistic, patient-centred approach to its management.