1030 BELIEFS ABOUT SLEEP IN PEOPLE WITH PSORIASIS: AN IN-DEPTH QUALITATIVE STUDY USING THE COMMON-SENSE MODEL OF SELF-REGULATION FRAMEWORK

Abstract

Psoriasis a common, complex, long-term inflammatory condition primarily affecting the skin, is associated with significant physical and psychological comorbidity. Sleep disturbance is frequently reported by people with psoriasis and is associated with pre-sleep arousal, itch and low mood. This is the first study to our knowledge that explores in-depth the beliefs people with psoriasis hold about sleep. We used the established Common-Sense Self-Regulation Model (CS-SRM) as a theoretical framework. Semi-structured interviews were conducted in a purposive sample of 9 people with psoriasis. The interviewer explored participants’ beliefs about their sleep (characteristics of sleep patterns; timeline; causes of good/poor sleep; consequences of poor sleep and beliefs about the curability/controllability of poor sleep) and coping strategies used. Data were analysed using principles of framework and thematic analysis. Five key themes emerged within the dimensions of the CS-SRM: 1) ‘Dissatisfaction with sleep’: reduced sleep quality and duration and difficulty initiating sleep; 2) ‘Sleep varies by perceptions of psoriasis’; sleep disturbance triggered by psoriasis symptoms, and sleep changes as a function of time since treatment; 3) ‘Heightened awareness of psoriasis at night’; symptom management and thoughts/worries about psoriasis contributing to sleep disturbance 4) ‘Sleep affecting multiple domains of life’; consequences of sleep disturbance on work, social and family life 5) ‘Perceived lack of control of sleep’: a constant battle for control over sleep, increased effort to sleep and resigned acceptance of poor sleep. Patients report strong links between sleep disturbance and psoriasis symptoms and management in a bi-directional manner that require further testing. The CS-SRM appears to be a valid theoretical model for assessing the beliefs about sleep in people with psoriasis. This work was supported by a grant from The Psoriasis Association of Great Britain and Northern Ireland (R117541)