Insomnia and other sleep complaints in inflammatory versus noninflammatory skin disorders: An observational case‐control study

Abstract

BACKGROUND: Sleep problems are common in patients with dermatologic disorders. However, it is unknown whether inflammatory skin disorders are associated with more sleep problems than noninflammatory skin disorders. PURPOSE: To determine whether sleep problems occur more frequently in people with inflammatory skin disorders compared to noninflammatory skin disorders. STUDY DESIGN: Observational case-control study. METHODS: Patients with inflammatory skin disorders (psoriasis [n = 17] and chronic eczema [n = 30]) and noninflammatory skin disorders (nonmelanoma skin cancers [NMSC] [n = 31]) were enrolled. Data collection occurred during a single visit. Statistical analysis of questionnaire results between groups utilized inverse propensity score weighted (IPSW) ANOVA and logistic regression models. RESULTS: Groups differed in mean (SD) age (P < 0.001) and itch severity (P < 0.001). Based on IPSW ANOVA models, the inflammatory group had significantly higher fatigue scores (mean [95% CI]; 32.0 [28.4-35.5]) than the noninflammatory group (25.5 [21.6-29.3]; P = 0.017). The inflammatory group odds of insomnia were significantly greater based on two definitions of insomnia, ISI ≥ 15 and PSSQ-I, with odds ratios (95% CI) of 14.4 (2.16-525) and 4.82 (1.45-20.7), respectively. These results were consistent in comparisons between the three groups, with no difference between psoriasis and chronic eczema, but with chronic eczema, significantly more were affected than NMSC. CONCLUSIONS: Patients with inflammatory skin disorders report significantly more fatigue and have higher odds of insomnia compared to patients with noninflammatory skin cancers.