Pruritus may lead to sleep disturbance, psychological distress
Dermatology patients with consistent and high levels of pruritus reported frequent sleep disturbance and psychological distress, according to a study.
“Sleep disturbance remains insufficiently characterized in many dermatoses,” Max Spindler, MD, of the department of dermatology and allergy at Charité – Universitätsmedizin Berlin in Germany, and colleagues wrote.
In the study, Spindler and colleagues recruited 800 adult patients with pruritus to determine prevalence, burden and other factors associated with poor sleep. They recorded characteristics of pruritus, along with relevant sociodemographic and clinical data.
In addition, patients completed surveys assessing not only sleep disturbance, but psychological distress, work productivity and other health-related quality of life parameters.
Results showed that two-thirds of the cohort fulfilled criteria for poor sleep, with 82.9% reporting difficulty falling asleep and 76.3% reporting difficulty waking up. Patients with an average pruritus score exceeding 5 points and with a maximum of 6.5 points were at particularly high risk for pruritus-associated sleep disturbance.
Other findings showed that psychological distress may be a more significant contributor to sleep disturbance than pruritus, with 31% of the relationship between pruritus intensity and sleep mediated by psychological factors (mediation proportion, 0.309).
Overall, psychological distress was the most important predictor of sleep disturbance. Nocturnal exacerbation of pruritus also contributed to sleep disturbance, as did pruritus intensity and number of comorbidities.
Other factors that contributed to poor sleep included female sex, obesity, unemployment and living alone.
“Dermatologic patients with intense pruritus and psychological distress should be examined for sleep disorders,” the researchers wrote. “Adequate antipruritic therapy and complementary psychotherapy in affected patients may help them regain restorative sleep.”